Organization
EYECARE ASSOCIATES OF EASTGATE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA WINBIGLER (OFFICE MANAGER)
(208) 344-8758
Entity
Organization
Contact information
Practice address
939 W. BEACON ST, BOISE, ID 83706-5118
(208) 344-8758
(208) 331-3379
Mailing address
939 W. BEACON ST, BOISE, ID 83706-5118
(208) 344-8758
(208) 331-3379
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
ODP-718
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015349
BLUE SHIELD
ID
05
—
002622500
—
ID
01
—
V6622
BLUE CROSS
ID
Enumeration date
01/04/2007
Last updated
11/29/2011
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