Idaho Eye Center Pa

LBN: Idaho Eye Center Pa
Idaho Eye Center Pa is an health care organization with primary practice located at 2025 E 17Th St , Idaho Falls ID 83404. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as the primary health care specialty. Idaho Eye Center Pa can be contacted via phone (208) 524-2025, or through Gardner, Bradley P via phone (208) 524-2025.

Contact Information

Primary practice address
2025 E 17Th St Idaho Falls ID 83404
Phone: (208) 524-2025
Fax: (208) 529-1924
Website:
Map and Directions
Authorized official contact:
Name: Gardner, Bradley P Doctor of Medicine (MD)
Phone: (208) 524-2025

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X

Profile Details

NPI number 1518021849
LBN Legal business name Idaho Eye Center Pa
DBA Doing business as
Authorized official Gardner, Bradley P Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 21st, 2006
Last updated Aug 20th, 2008 - about 17 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 1518021849 NPPES
Idaho Other 8C626 BLUE CROSS
Idaho Other 8F876 BLUE CROSS
Idaho Other 8E837 BLUE CROSS
Idaho Other 84434 BLUE CROSS

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