Organization
ADA VISION CENTER P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN ROLFS PD (PRESIDENT)
(208) 336-2020
Entity
Organization
Contact information
Practice address
1333 W JEFFERSON ST, BOISE, ID 83702-5320
(208) 336-2020
(208) 384-5677
Mailing address
1333 W JEFFERSON ST, BOISE, ID 83702-5320
(208) 336-2020
(208) 384-5677
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138576
REGENCE BLUE SHIELD
ID
05
—
U80987
—
ID
01
—
V7042
BLUE CROSS OF IDAHO
ID
Enumeration date
08/13/2006
Last updated
08/01/2024
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