Eye Clinic Of Sandpoint Pa in Sandpoint - Eyewear Supplier
Eye Clinic Of Sandpoint Pa - NPI 1104957612
Eye Clinic Of Sandpoint Pa is a Eyewear Supplier in Sandpoint, Idaho. Eye Clinic Of Sandpoint Pa practices all healthcare services and medical treatments related to Eyewear Supplier. The NPI Number for Eye Clinic Of Sandpoint Pa is 1104957612. The last update date is 2018-02-15.
Eye Clinic Of Sandpoint Pa's current location address is 307 S 1st Ave, Sandpoint, Idaho. You can contact this provider via phone number 2082638501. The mailing address for Eye Clinic Of Sandpoint Pa is 307 S 1st Ave, Sandpoint, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Eye Clinic Of Sandpoint Pa |
|---|---|
| Address | 307 S 1st Ave, Sandpoint, Idaho |
| Phone Number | 2082638501 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHYSICIAN- |
|---|---|
| Authorized Official Name | Petersen M Jason |
| Credentials | DO |
| Telephone Number | 2082638501 |
NPI Number Detail
| NPI Number | 1104957612 |
|---|---|
| Provider Enumeration Date | 2007-03-08 |
| Last Updated Date | 2018-02-15 |
Provider Mailing Address Detail
| Address | 307 S 1st Ave |
|---|---|
| City | Sandpoint |
| State | Idaho (ID) |
| Post Code | 838641201 |
| Phone Number | 2082638501 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Eyewear Supplier |
|---|---|
| Taxonomy | 332H00000X |
|
Definition: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 377150001 | ID | NORIDIAN DMERC SUPPLIER |
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What is the Eye Clinic Of Sandpoint Pa's unique identification number?
The Eye Clinic Of Sandpoint Pa has been assigned the NPI (National Provider Identifier) Number 1104957612 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Eye Clinic Of Sandpoint Pa?
The Eye Clinic Of Sandpoint Pa is situated at 307 S 1St Ave, in the city of Sandpoint, state of ID, with the zip code 838641201.
What is the Eye Clinic Of Sandpoint Pa's specialty and taxonomy code?
The Eye Clinic Of Sandpoint Pa's specialty is Eyewear Supplier, and the corresponding taxonomy code is 332H00000X.
When did the Eye Clinic Of Sandpoint Pa receive its 1104957612?
The Eye Clinic Of Sandpoint Pa was issued its 1104957612 on 2007-03-08, which is the date when the organization was assigned this unique identifier.
When was the information regarding Eye Clinic Of Sandpoint Pa, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Eye Clinic Of Sandpoint Pa, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2018-02-15.