HENRY'S FORK SURGERY CENTER PLLC (NPI# 1235768490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235768490 |
| Entity Type | Organization |
| Organization Name | HENRY'S FORK SURGERY CENTER PLLC |
| Practice Address |
23 Sawtelle Ave Rexburg ID 83440 |
| Mailing Address |
Po Box 6 Rexburg ID 83440-0006 |
| Practice Telephone | 2083591888 |
| Practice Fax Number | 2083591889 |
| Mailing Telephone | 2083591888 |
| Mailing Fax Number | 2083591888 |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-04-30 |
| Authorized Official Name | HOLLY ALLEN (MANAGER) |
| Authorized Official Telephone | 2083591888 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1447301395 | 05 |
| Street Address |
23 SAWTELLE AVE |
| City | REXBURG |
| State | ID |
| Zip Code | 83440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952956906 | Shane Ellis Withers | Pharmacist | 164 E. Main, Rexburg, ID 83440 | 2019-08-06 |
| 1316392285 | Emma Anderson | Speech-Language Pathologist | 36 Professional Plaza Suite 110, Rexburg, ID 83440 | 2016-04-28 |
| 1851755524 | Sandra Frickey | Speech-Language Pathologist | 1087 Summers Drive, Premier Therapy Associates, Rexburg, ID 83440 | 2016-04-08 |
| 1275997215 | Kerry Denney | Counselor | 333 Walker Drive, Rexburg, ID 83440 | 2016-04-06 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1649692609 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 410 W 1st N, Rexburg, ID 83440 | 2014-01-10 |
| 1043652571 | Creed Simon Webster | Counselor | 30 S 2nd W, Rexburg, ID 83440 | 2013-07-25 |
| 1033461660 | James Cannon Allen Dds PC | Dentist | 106 E 1st North, Rexburg, ID 83440 | 2012-10-05 |
| 1417217316 | Shelby Dee Woolstenhulme | Speech-Language Pathologist | 450 E. Main Street, Rexburg, ID 83440 | 2012-05-24 |
| 1841563335 | Eric Andreasen | Physical Therapist | 393 East Second North, Rexburg, ID 83440 | 2012-02-15 |
| Find all providers in zip 83440 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821420571 | Upper Valley Surgery Center | Clinic/Center | 256 N 200 E, Rexburg, ID 83440-2048 | 2013-08-05 |
| 1831134584 | Rexburg Surgery Center LLC | Clinic/Center | 381 East 4th North, Suite 200, Rexburg, ID 83440 | 2006-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043835713 | Idaho Endoscopy Center LLC | Clinic/Center | 5080 E Commerce St, Nampa, ID 83687-5513 | 2020-06-09 |
| 1467097725 | Center for Surgery Pllc | Clinic/Center | 3369 Merlin Dr Ste A, Idaho Falls, ID 83404-7405 | 2019-11-11 |
| 1831636752 | River View Surgery Center, LLC | Clinic/Center | 1502 Locust St N Ste 100, Twin Falls, ID 83301-4163 | 2017-01-30 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1558733147 | River City Surgical Center | Clinic/Center | 10118 W Overland Rd, Boise, ID 83709-1428 | 2015-10-22 |
| 1669720397 | Pleasant View Surgery Center, LLC | Clinic/Center | 4171 West Expo Parkway, Post Falls, ID 83854 | 2012-08-28 |
| 1851552483 | Skyline Surgery Center, LLC | Clinic/Center | 285 Vista Dr, Ste C, Pocatello, ID 83201 | 2008-06-17 |
| 1255500427 | Les Bois Surgery Center, LLP | Clinic/Center | 8950 W Emerald St Ste 164, Boise, ID 83704-8296 | 2008-02-21 |
| 1740479476 | Meadow Lake Surgery Center Inc | Clinic/Center | 3630 E Louise Dr, Suite 200, Meridian, ID 83642-7975 | 2007-10-18 |
| 1285825075 | Sunnyside Surgery Center, LLC | Clinic/Center | 3345 S Holmes Ave Ste B, Idaho Falls, ID 83404-7981 | 2007-08-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.