Hacking, Sally

Hacking, Sally is an individual health care provider with primary practice located at 244 E Main St , Rexburg ID 83440-2022. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Hacking, Sally can be contacted via phone (208) 359-1880.

Contact Information

Primary practice address
244 E Main St Rexburg ID 83440-2022
Fax: (208) 359-2025
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP 100024 Idaho

Profile Details

NPI number 1609982271
LBN Legal business name Hacking, Sally
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Jul 9th, 2007 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609982271 NPPES
Idaho Other 863683 DESERET MUTUAL
Idaho Other 000010147629 DESERET MUTUAL
Idaho MEDICAID 806951200 DESERET MUTUAL
Idaho Other V6507 DESERET MUTUAL

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