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ADA COUNTY EYECARE

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Company Details

Name: ADA COUNTY EYECARE
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 06 Jan 1997 (28 years ago)
Entity Number: 442
Place of Formation: IDAHO
File Number: 0000000442
ZIP code: 83709
County: Ada County
Mailing Address: 9766 MARTINGALE BOISE, ID 83709

National Provider Identifier

NPI Number:
1619185485

Authorized Person:

Name:
STEVEN M. POLATIS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
152WC0802X - Corneal and Contact Management Optometrist
Is Primary:
Yes

Contacts:

Fax:
2083451137

Filing

Filing Name Filing Number Filing date
Initial Filing 0000000442 1997-01-06

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Date of last update: 22 Sep 2024

Sources: Idaho Secretary of State