Intermountain Ocular Prosthetics, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

INTERMOUNTAIN OCULAR PROSTHETICS, INC.

Practice address

2308 W Overland Rd
Boise, ID 83705-3152

Phone

(208) 378-8200

NPI assigned

Sep 26, 2006

Last updated

Feb 13, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Sam F Murano II, BCO, BADO

Title

President

Phone

(208) 378-8200

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Intermountain Ocular Prosthetics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Intermountain Ocular Prosthetics, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Boise, ID
  • NPI 1356352041
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234483200000",
    "number": "1801997234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053152",
            "telephone_number": "208-378-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053152",
            "telephone_number": "208-378-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN OCULAR PROSTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2009-02-13",
        "status": "A",
        "authorized_official_last_name": "MURANO",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-378-8200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "BCO, BADO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005600854",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278130",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113182600",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805051400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Intermountain Eye and Laser Centers PLLC (Intermountain Eye Centers)
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• Intermountain Hand Clinic PA
• Intermountain Medical Imaging LLC
• Intermountain Ocular Prosthetics, Inc.
• Intermountain Orthopaedic PLLC
• Intermountain Orthopaedics Specialists
• Intermountain Surgery Center
• Intermountian Pediatric Clinic PA
• International Rescue Committee, Inc.

• Durable Medical Equipment & Medical Supplies in Boise, ID
• Providers in Boise, ID by specialty
• Durable Medical Equipment & Medical Supplies in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.