Organization
COEUR D ALENE OPTICAL, INC.
Active
Other names
Post Falls Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEDE KAREN SINES (ADMINISTRATOR)
(208) 667-2531
Entity
Organization
Contact information
Practice address
1814 LINCOLN WAY, COEUR D ALENE, ID 83814-2540
(208) 667-2531
(208) 765-9385
Mailing address
1814 LINCOLN WAY, COEUR D ALENE, ID 83814-2540
(208) 667-2531
(208) 765-9385
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010014269
REGENCE BLUE SHIELD OF ID
ID
Enumeration date
01/29/2007
Last updated
07/06/2010
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