Provider Demographics
NPI:1750656765
Name:ENCORE VISION, INC
Entity Type:Organization
Organization Name:ENCORE VISION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-482-9037
Mailing Address - Street 1:1039 21ST ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-3415
Mailing Address - Country:US
Mailing Address - Phone:208-413-6685
Mailing Address - Fax:208-413-6687
Practice Address - Street 1:7826 N MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217-7857
Practice Address - Country:US
Practice Address - Phone:509-482-9037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCORE VISION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-09
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier