Vision Quest Medical Center, Pa
LBN: Vision Quest Medical Center, Pa
Vision Quest Medical Center, Pa is an health care organization with primary practice located at 5680 W Gage St , Boise ID 83706-1326. The organization recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology, Suppliers / Durable Medical Equipment & Medical Supplies. Suppliers / Durable Medical Equipment & Medical Supplies is the primary health care specialty.
Vision Quest Medical Center, Pa can be contacted via phone (208) 377-3937, or through Mong, Jacob A via phone (208) 377-3937.
Contact Information
Primary practice address
5680 W Gage St
Boise ID 83706-1326
Phone: (208) 377-3937
Fax: (208) 377-9455
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-100002 | Idaho |
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP100417 | Idaho |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | O-0860 | Idaho |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1003873852 |
|---|---|
| LBN Legal business name | Vision Quest Medical Center, Pa |
| DBA Doing business as | |
| Authorized official | Mong, Jacob A Doctor of Osteopathy (DO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Nov 21st, 2017 - about 7 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 | 1003873852 | NPPES |
| Idaho | MEDICAID | 807072200 | |
| Idaho | MEDICAID | 807072300 |
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