Maple Grove Eye Clinic
LBN: Lawrence D Anderson Md Estate
Maple Grove Eye Clinic is an health care organization with primary practice located at 8955 W Hackamore Dr , Boise ID 83709. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is the primary health care specialty.
Lawrence D Anderson Md Estate can be contacted via phone (208) 344-7944, or through Anderson, Nathan B via phone (208) 344-7944.
Contact Information
Primary practice address
8955 W Hackamore Dr
Boise ID 83709
Phone: (208) 344-7944
Fax: (208) 343-4676
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ||
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X |
Profile Details
| NPI number | 1326550096 |
|---|---|
| LBN Legal business name | Lawrence D Anderson Md Estate |
| DBA Doing business as | Maple Grove Eye Clinic |
| Authorized official | Anderson, Nathan B |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 2nd, 2017 |
| Last updated | Apr 10th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326550096 | NPPES |
| Idaho | MEDICAID | 1942316054 | |
| Idaho | MEDICAID | 1326302548 |
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