| Gem Vision, Pc | |
|
316 S Washington Ave Emmett ID 83617-2952 | |
| (208) 365-8865 | |
| Not Available |
| Full Name | Gem Vision, Pc |
|---|---|
| Speciality | Optometrist |
| Location | 316 S Washington Ave, Emmett, Idaho |
| Authorized Official Name and Position | Christopher Kimball (OWNER) |
| Authorized Official Contact | 2083658865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gem Vision, Pc 316 S Washington Ave Emmett ID 83617-2952 Ph: (208) 365-8865 | Gem Vision, Pc 316 S Washington Ave Emmett ID 83617-2952 Ph: (208) 365-8865 |
| NPI Number | 1336734326 |
|---|---|
| Provider Enumeration Date | 03/02/2021 |
| Last Update Date | 12/15/2022 |
| Medicare PECOS PAC ID | 1456769033 |
|---|---|
| Medicare Enrollment ID | O20210420001882 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336734326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Christopher Don Kimball |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265988810 PECOS PAC ID: 1951669910 Enrollment ID: I20180321000406 |
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