Provider Demographics
NPI:1316096993
Name:CHRIS HARMON LLC DBA EYE VALU VISION CENTER
Entity type:Organization
Organization Name:CHRIS HARMON LLC DBA EYE VALU VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-732-0435
Mailing Address - Street 1:705 BLUE LAKES BLVD N
Mailing Address - Street 2:SUITE B
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-4007
Mailing Address - Country:US
Mailing Address - Phone:208-732-0435
Mailing Address - Fax:208-732-0435
Practice Address - Street 1:705 BLUE LAKES BLVD N
Practice Address - Street 2:SUITE B
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-4007
Practice Address - Country:US
Practice Address - Phone:208-732-0435
Practice Address - Fax:208-732-0435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier