Tree City Eyecare Pllc | |
700 N Raymond St, Boise, ID 83704-9261 | |
(208) 375-3871 | |
(208) 321-1765 |
Full Name | Tree City Eyecare Pllc |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 700 N Raymond St, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598940421 | NPI | - | NPPES |
20015736 | Other | ID | MEDICARE ID |
15989404214 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
152WC0802X | Optometrist - Corneal And Contact Management | (* (Not Available)) | Secondary |
Provider Name | Randolph Lee |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1427091677 PECOS PAC ID: 6002099132 Enrollment ID: I20110325000770 |
Mailing Address | Practice Location Address |
---|---|
Tree City Eyecare Pllc 700 N Raymond St, Boise, ID 83704-9261 Ph: (208) 375-3871 | Tree City Eyecare Pllc 700 N Raymond St, Boise, ID 83704-9261 Ph: (208) 375-3871 |
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