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GRANGE SURGERY CENTER PLLC
NPI 1316663032
Clinic/Center - Ambulatory Surgical in Eagle, ID

Active since October 14, 2022
450 W STATE ST STE 250, EAGLE, ID 83616(208) 506-7966 Get Directions Write a Review

NPPES record last updated: August 22, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 22, 2023, Jan 23, 2023, Oct 14, 2022 (3 updates tracked since 2022).

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Secondary Taxonomies
  4. Authorized Official
  5. Other Providers Same Location
  6. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Ambulatory Surgical

About GRANGE SURGERY CENTER PLLC

This page provides the complete NPI Profile along with additional information for Grange Surgery Center Pllc, a provider established in Eagle, Idaho operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1316663032 assigned on October 2022. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Landon Grange Md (Medical Director)

NPI
1316663032 Verify this NPI
Provider Name
GRANGE SURGERY CENTER PLLC
Entity Type
Organization
Location Address
450 W STATE ST STE 250 EAGLE, ID 83616
Location Phone
(208) 506-7966
Mailing Address
450 W STATE ST STE 250 EAGLE, ID 83616
Mailing Phone
(208) 506-7966
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-14-2022
Last Update Date
08-22-2023
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization		 License No. (State)
1261QS0132XAmbulatory Health Care Facilities

Clinic/Center
Ophthalmologic Surgery

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

LANDON GRANGE MD

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(208) 506-7966

Reviews for GRANGE SURGERY CENTER PLLC

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

GRANGE OPHTHALMOLOGY, PLLC
Ophthalmology
450 W STATE ST STE 250
EAGLE, ID 83616
Ada County (208) 506-7966

Frequently Asked Questions

What is GRANGE SURGERY CENTER PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1316663032, enumerated as an "organization" on October 14, 2022.

Where is the provider located?

The provider is located at 450 W STATE ST STE 250 EAGLE, ID 83616 and the phone number is (208) 506-7966.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.