LITTLE MO'S OPTICAL BOUTIQUE


Address: 1720 Lincoln Way, Coeurd Alene, ID 83814
Phone: 2086644011

LITTLE MO'S OPTICAL BOUTIQUE (NPI# 1841332343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841332343
Entity Type Organization
Organization Name LITTLE MO'S OPTICAL BOUTIQUE
Practice Address 1720 Lincoln Way
Coeurd Alene
ID 83814
Practice Telephone 2086644011
Practice Fax Number 2086644022
Mailing Telephone 2086644011
Mailing Fax Number 2086644022
Enumeration Date 2007-02-12
Last Update Date 2008-09-16
Authorized Official Name LYNN C ERICKSON (OWNER)
Authorized Official Telephone 2086644011
Authorized Official Credential OPTICIAN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 332H00000X Eyewear Supplier (Equipment, not the service) ID Suppliers
Y 156FX1800X Technician/Technologist
Specialization: Optician
ID Eye and Vision Services Providers

Office Location

Street Address 1720 LINCOLN WAY
City COEURD ALENE
State ID
Zip Code 83814

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Taxonomy Information

Taxonomy Code 156FX1800X
Grouping Eye and Vision Services Providers
Classification Technician/Technologist
Specialization Optician

Taxonomy Definition

Definition to come...

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Competitor

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City COEURD ALENE
Zip Code 83814

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Dataset Information

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.

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