PEABODY OPTICAL (NPI# 1255757738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255757738 |
| Entity Type | Organization |
| Organization Name | PEABODY OPTICAL |
| Practice Address |
409 S 8th St Ste 101 Boise ID 83702-7136 |
| Mailing Address |
9720 S 1300 E Ste E200 Sandy UT 84094-3768 |
| Practice Telephone | 2083441390 |
| Mailing Telephone | 8015766433 |
| Mailing Fax Number | 8015765643 |
| Enumeration Date | 2014-03-08 |
| Last Update Date | 2014-05-21 |
| Authorized Official Name | MATHEW PETERSEN (MEMBER) |
| Authorized Official Telephone | 8015766433 |
| Authorized Official Credential | ABOC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Street Address |
409 S 8TH ST STE 101 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-7136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629420526 | Brad Linder | Technician/Technologist | 409 S 8th St Ste 101, Boise, ID 83702-7136 | 2016-07-05 |
| 1306298203 | Alma Tufeckcic | Technician/Technologist | 409 S 8th St Ste 101, Boise, ID 83702-7136 | 2016-07-05 |
| 1972955870 | Erin Aldape | Technician/Technologist | 409 S 8th St Ste 101, Boise, ID 83702-7136 | 2016-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447439674 | The Frame Joint | Eyewear Supplier (Equipment, not the service) | 7905 W Ustick Rd, Suite E, Boise, ID 83704-5001 | 2007-10-24 |
| 1386799781 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 8359 W Emerald St, Boise, ID 83704 | 2007-01-24 |
| 1437207909 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 460 N Milwaukee, Boise Towne Square Mall, Boise, ID 83704-9122 | 2007-01-08 |
| 1407863145 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 300 N. Milwaukee, Boise, ID 83704 | 2006-08-02 |
| 1063803278 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 2051 S Cole Rd, Boise, ID 83709-2815 | 2015-02-10 |
| 1336547371 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 291 N Milwaukee St, Suite A-3, Boise, ID 83704-9132 | 2014-12-08 |
| 1265589048 | Eyecare Associates of Eastgate Pa | Eyewear Supplier (Equipment, not the service) | 939 W. Beacon St, Boise, ID 83706-5118 | 2007-01-04 |
| 1134295116 | Boise Vision Care, P.a. | Eyewear Supplier (Equipment, not the service) | 3293 N Milwaukee St, Boise, ID 83704-4446 | 2006-11-28 |
| 1235221268 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 350 N Milwaukee St, Suite 1188, Boise, ID 83704-9123 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972169357 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2331 Thain Grade Ste 101, Lewiston, ID 83501-4119 | 2019-05-11 |
| 1063078442 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 212 W Ironwood Dr Ste B&c, Coeur D Alene, ID 83814-1403 | 2019-05-11 |
| 1972096469 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 4013 Yellowstone Ave Ste D&e, Chubbuck, ID 83202-1932 | 2018-06-11 |
| 1023528320 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1605 Blue Lakes Blvd N # A, Twin Falls, ID 83301-3322 | 2017-10-02 |
| 1114268257 | Eyemart Express Ltd | Eyewear Supplier (Equipment, not the service) | 2990 S 25th E, Idaho Falls, ID 83404-6515 | 2013-03-14 |
| 1720212632 | Walmart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 1551 Washington St. N, Twin Falls, ID 83301 | 2009-05-06 |
| 1275715757 | Panhandle Eye Clinics Chartered | Eyewear Supplier (Equipment, not the service) | 704 W College Ave, St Maries, ID 83861-1824 | 2007-11-27 |
| 1255452843 | Optical Illusions Inc | Eyewear Supplier (Equipment, not the service) | 3160 E 17th St, Suite 150, Ammon, ID 83406-6717 | 2007-04-02 |
| 1346378304 | I Care Optical LLC | Eyewear Supplier (Equipment, not the service) | 1017 12th Ave S, Nampa, ID 83651-4660 | 2007-03-01 |
| 1841332343 | Little Mo's Optical Boutique | Eyewear Supplier (Equipment, not the service) | 1720 Lincoln Way, Coeurd Alene, ID 83814 | 2007-02-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PEABODY OPTICAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.