Aspen Ridge Eye Care, Pllc

LBN: Aspen Ridge Eye Care, Pllc
Aspen Ridge Eye Care, Pllc is an health care organization with primary practice located at 3456 E 17Th St Suite 150, Ammon ID 83406-6757. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Aspen Ridge Eye Care, Pllc can be contacted via phone (208) 528-6900, or through Carlson, Jerry D via phone (208) 528-6900.

Contact Information

Primary practice address
3456 E 17Th St Suite 150 Ammon ID 83406-6757
Phone: (208) 528-6900
Fax: (208) 528-6904
Website:
Map and Directions
Authorized official contact:
Name: Carlson, Jerry D Doctor of Optometry (OD)
Phone: (208) 528-6900

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP-100104 Idaho

Profile Details

NPI number 1023223187
LBN Legal business name Aspen Ridge Eye Care, Pllc
DBA Doing business as
Authorized official Carlson, Jerry D Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 11th, 2007
Last updated May 1st, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023223187 NPPES
Idaho MEDICAID 807648800

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