Organization
ALAMEDA VISION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANECE FOWERS (BILLING MANAGER)
(208) 233-2020
Entity
Organization
Contact information
Practice address
1155 POCATELLO CREEK RD, POCATELLO, ID 83201-2949
(208) 233-2020
(208) 233-2021
Mailing address
1155 POCATELLO CREEK RD, POCATELLO, ID 83201-2949
(208) 233-2020
(208) 233-2021
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82413
BS
—
01
—
CP9184
RR MEDICARE
ID
01
—
U2498
BC
—
Enumeration date
11/30/2005
Last updated
08/29/2011
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