Eagle Vision Center Pc

LBN: Eagle Vision Center Pc
Eagle Vision Center Pc is an health care organization with primary practice located at 74 E 1St S , Rexburg ID 83440-1936. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Eagle Vision Center Pc can be contacted via phone (208) 356-6911, or through Galbraith, Shawn Taylor via phone (208) 356-6911.

Contact Information

Primary practice address
74 E 1St S Rexburg ID 83440-1936
Phone: (208) 356-6911
Fax: (208) 356-3185
Website:
Map and Directions
Authorized official contact:
Name: Galbraith, Shawn Taylor Doctor of Optometry (OD)
Phone: (208) 356-6911

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP100035 Idaho

Profile Details

NPI number 1467646265
LBN Legal business name Eagle Vision Center Pc
DBA Doing business as
Authorized official Galbraith, Shawn Taylor Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 5th, 2007
Last updated Nov 21st, 2012 - about 14 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 1467646265 NPPES
Idaho MEDICAID 807725600

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