NPIMap

Organization Active NPI

Eyemart Express LLC

  • Eyewear Supplier
  • Chubbuck, ID
National Provider Identifier
1972096469
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYEMART EXPRESS LLC
Practice address
4013 Yellowstone Ave Ste D&E
Chubbuck, ID 83202-1932
Phone
(208) 547-5012
Fax
(972) 277-3176
NPI assigned
Jun 11, 2018
Organization subpart
Yes
Parent organization
EYEMART EXPRESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Authorized official

Name
Kim Caruso
Title
Director of Credentialing
Phone
(212) 792-8136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

4013 Yellowstone Ave Ste D&E
Chubbuck, ID 83202-1932

Mailing address

4013 Yellowstone Ave Ste D&E
Chubbuck, ID 83202-1932
Phone (208) 547-5012

National Provider Directory

National Provider Directory
Tax ID family
Eyemart Express292 organizations share this tax ID, including this one
Part of
Eyemart Express

Organizations with this tax ID in the same state 5

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

4013 Yellowstone Ave
Ste De
Chubbuck, ID 83202
Phone (208) 547-5012

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1972096469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4013 YELLOWSTONE AVE STE D&E",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832021932",
            "telephone_number": "208-547-5012",
            "fax_number": "972-277-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 YELLOWSTONE AVE STE D&E",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832021932",
            "telephone_number": "208-547-5012",
            "fax_number": "972-277-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEMART EXPRESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYEMART EXPRESS LLC",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "CARUSO",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "212-792-8136"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.