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1871016071
PORTNEUF ASC, LLC
POCATELLO, ID
NPI
1871016071
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Entity Type
Organization
Authorized Contact
STEPHEN C PETROVICH
EVP
615-296-3000
Organization Subpart ?
Yes
Primary Taxonomy
261QA1903X Clinic/Center, Ambulatory Surgical
Enumeration Date
2017-07-19
Last Update Date
2017-07-19
Business Address
PORTNEUF ASC, LLC
1151 HOSPITAL WAY BLDG A
POCATELLO, ID 83201-5091
Phone number: 208-232-6616
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Mailing Address
PORTNEUF ASC, LLC
1 BURTON HILLS BLVD STE 250
NASHVILLE, TN 37215-6195
Phone number: 615-296-3000
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