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LEWISTON EYE CLINIC PA NPI 1598871899


NPI Information

NPI: 1598871899
Provider Name: LEWISTON EYE CLINIC PA
Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 13D1029187

Address:
2214 VINEYARD AVE
LEWISTON, ID
ZIP 83501
Phone: (208) 743-2241
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LEWISTON EYE CLINIC PA is an ophthalmology in Lewiston, ID. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. LEWISTON EYE CLINIC PA NPI is 1598871899. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2214 VINEYARD AVE
LEWISTON, ID
ZIP 83501
Phone: (208) 743-2241
Fax: (208) 743-5871

The provider's authorized official is Eugene Meehan Baldeck .
The authorized official title is Owner and has the following contact phone number (208) 743-2241.

The CLIA number assigned to this NPI record is 13D1029187 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyM2629IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1209714100000OTHERPREMERA
2D205000OTHERIDAHOREGENCE
326294OTHERIDAHOBLUE CROSS
4173777OTHERCOMBINED INS CO OF AMER
51022144MEDICAIDWASHINGTON
6548D7BAOTHERBLUE LINKS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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