Provider Demographics
NPI:1467674572
Name:EYE 2 EYE PLLC
Entity Type:Organization
Organization Name:EYE 2 EYE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHWERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:208-939-7000
Mailing Address - Street 1:440 E STATE ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-4966
Mailing Address - Country:US
Mailing Address - Phone:208-939-7000
Mailing Address - Fax:208-939-5807
Practice Address - Street 1:440 E STATE ST
Practice Address - Street 2:SUITE 140
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-4966
Practice Address - Country:US
Practice Address - Phone:208-939-7000
Practice Address - Fax:208-939-5807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDODP930152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000287600Medicaid
ID000287600Medicaid
ID1368473Medicare PIN
ID5052750001Medicare NSC