Cole Family Eye Center, PA
Organization Active NPI Corneal and Contact Management Optometrist · Boise, ID
NPI 1447540802 · NPPES record last updated Dec 31, 2013
Key facts
- NPI
- 1447540802
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Corneal and Contact Management Optometrist 152WC0802X
- License
- ODP-100177 (ID)
- Legal business name
- COLE FAMILY EYE CENTER, PA
- Practice address
- 8102 W Northview St
Boise, ID 83704 - Phone
- (208) 377-1102
- Fax
- (208) 377-5853
- NPI assigned
- Apr 19, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Brent A Galvan, O.D.
- Title
- Owner
- Phone
- (208) 377-1102
Practitioners 2
-
Brent Anthony Galvan, O.D.
-
Candice Anne Galvan, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110713000473 | ID | Part B Supplier - Clinic/Group Practice | 6709054984 |
Receives reassigned benefits from 1 practitioner Practice locations: Boise, ID |
National Provider Directory
Locations
8102 W Northview St
Boise, ID 83704
Phone (208) 377-1102
3421 N Cole Rd
Boise, ID 83704
Phone (208) 377-1102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist |
152WC0802X | ODP-100177 | ID | Yes |
Addresses
Primary practice location
8102 W Northview St
Boise, ID 83704
Mailing address
8102 W Northview St
Boise, ID 83704-4406
Phone (208) 377-1102
Other names
- Boise Family Eye Center
Other providers in Boise, ID
- Coire Weathers, MD, PLLC
- Rosemary Coldsnow
- Stuart Coldsnow
- Cole Dental
- Cole Diagnostics, Inc
- Michelle Denise Cole-Riccardi
- Mycellia Cole-Thurow
- Jerry Kevin Cole
- John Robert Cole
- Karen Lee Cole
All providers in Boise, ID · Corneal and Contact Management Optometrist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.