PANHANDLE EYE CLINICS CHARTERED; NPI #1275715757

Contact Information

PANHANDLE EYE CLINICS CHARTERED

704 W COLLEGE AVE
SAINT MARIES, ID 83861-1824

Phone: 208-245-6563
Fax: 208-245-6564
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Eyewear Supplier	332H00000X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for PANHANDLE EYE CLINICS CHARTERED

NPI # 1275715757

LBN Legal business name PANHANDLE EYE CLINICS CHARTERED

Authorized official ROBERT MAGWIRE - (DOCTOR/OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/27/2007

Last updated 07/02/2010 - About 16 years ago

Identifiers

ID	License #	ODD382
ID	Medicaid	002692300
ID	Other	V0179	BLUE CROSS OF IDAHO
ID	Other	0000100159391	REGENCE BLUESHIELD

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PANHANDLE EYE CLINICS CHARTERED

Contact Information

Specialty

Eyewear Supplier

NPI Profile & details for PANHANDLE EYE CLINICS CHARTERED

Reviews for PANHANDLE EYE CLINICS CHARTERED