Provider Demographics
NPI:1295875433
Name:PARIS INVESTMENTS LLC
Entity type:Organization
Organization Name:PARIS INVESTMENTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:208-882-3434
Mailing Address - Street 1:1205 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-3705
Mailing Address - Country:US
Mailing Address - Phone:208-882-3434
Mailing Address - Fax:208-883-4229
Practice Address - Street 1:1205 E 6TH ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-3705
Practice Address - Country:US
Practice Address - Phone:208-882-3434
Practice Address - Fax:208-883-4229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002595000Medicaid
IDT44363Medicare UPIN
ID1370555Medicare ID - Type Unspecified
ID002595000Medicaid