Hayden Vision Source Pllc

LBN: Hayden Vision Source Pllc
Hayden Vision Source Pllc is an health care organization with primary practice located at 8445 N Government Way , Hayden ID 83835-9349. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Hayden Vision Source Pllc can be contacted via phone (208) 772-3208, or through Putney, Emily via phone (208) 772-3208.

Contact Information

Primary practice address
8445 N Government Way Hayden ID 83835-9349
Phone: (208) 772-3208
Fax: (208) 762-2574
Website:
Map and Directions
Authorized official contact:
Name: Putney, Emily CPC
Phone: (208) 772-3208

Health care specialties

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

Profile Details

NPI number 1548999840
LBN Legal business name Hayden Vision Source Pllc
DBA Doing business as
Authorized official Putney, Emily CPC
Entity Organization
Organization subpart 1 No
Enumeration date Jun 10th, 2022
Last updated Jun 10th, 2022 - about 3 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 1548999840 NPPES
Idaho MEDICAID 1780345264

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