Ketchum Eyecenter

LBN: Eyecenter Pa
Ketchum Eyecenter is an health care organization with primary practice located at 180 1St Ave N , Ketchum ID 83340-6129. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Eyecenter Pa can be contacted via phone (208) 726-3363, or through Grill, Robert B via phone (208) 734-9800.

Contact Information

Primary practice address
180 1St Ave N Ketchum ID 83340-6129
Phone: (208) 726-3363
Fax: (208) 726-0138
Website:
Map and Directions
Authorized official contact:
Name: Grill, Robert B Doctor of Optometry (OD)
Phone: (208) 734-9800

Health care specialties

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

Profile Details

NPI number 1174632244
LBN Legal business name Eyecenter Pa
DBA Doing business as Ketchum Eyecenter
Authorized official Grill, Robert B Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 30th, 2006
Last updated Jan 8th, 2008 - about 18 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 1174632244 NPPES
Other CP7637 TRAVELERS RR MEDICARE GRP

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