Andregg, Randy L
Andregg, Randy L is an individual health care provider with primary practice located at 610 Americana Blvd , Boise ID 83702-6731. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Andregg, Randy L can be contacted via phone (208) 344-2020.Contact Information
Primary practice address
610 Americana Blvd
Boise ID 83702-6731
Phone: (208) 344-2020
Fax: (208) 344-2371
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP540 | Idaho |
Profile Details
| NPI number | 1245321835 |
|---|---|
| LBN Legal business name | Andregg, Randy L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Feb 27th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245321835 | NPPES |
| Idaho | MEDICAID | 0043245 |
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