MEDICARE: EYEMART EXPRESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1902691090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYEMART EXPRESS LLC

Provider Business Mailing Address
First Line	:	7307 NORTH CULTURE WAY
Second Line	:
City	:	COEUR D'ALENE
State	:	ID
Zip	:	83815
Country	:	US
Telephone Number	:	208-956-0017
Fax Number	:	208-956-0018

Provider Business Practice Location Address
First Line	:	7307 NORTH CULTURE WAY
Second Line	:
City	:	COEUR D'ALENE
State	:	ID
Zip	:	83815
Country	:	US
Telephone Number	:	208-956-0017
Fax Number	:	208-956-0018

Authorized Official
Title or Position	:	DIRECTOR OF CREDENTIALING
Name	:	KIM CARUSO
Credential	:
Telephone Number	:	646-660-1993

Provider Enumeration Date	:	04/10/2025
Last Update Date	:	04/10/2025

Similar Medicare Providers

1487503850 — SHELLY D SANDERS LCSW, LLC
Practice Location Address:

2454 W GRENOBLE LN
COEUR D ALENE, ID
83815-0481

Practice Phone: 208-964-2113
Practice Fax: 208-964-2113

1043169485 — MORIAH JEAN WHITE
Practice Location Address:

1704 E THOMAS LN
COEUR D ALENE, ID
83815-6478

Practice Phone: 208-997-8446
Practice Fax:

1144507575 — RYAN SOUSLEY DC
Practice Location Address:

2634 N GOVERNMENT WAY
COEUR D ALENE, ID
83815-3750

Practice Phone: 208-771-4474
Practice Fax:

1811618929 — MRS. DAWN C BROSE-STOWE LCSW
Practice Location Address:

7905 N MEADOWLARK WAY STE B
COEUR D ALENE, ID
83815-5041

Practice Phone: 208-772-3116
Practice Fax: 208-772-7677

1053261354 — ELAINA VASQUEZ
Practice Location Address:

7905 N MEADOWLARK WAY
COEUR D ALENE, ID
83815-5041

Practice Phone: 208-618-2709
Practice Fax:

1609354109 — CANOPY VILLAGE INC.
Practice Location Address:

1350 W HANLEY AVE
COEUR D ALENE, ID
83815-8638

Practice Phone: 208-667-1189
Practice Fax:

1649139148 — MELISSA M STROBECK BSN RN
Practice Location Address:

7190 N WINTER VIEW DR
COEUR D ALENE, ID
83815-9191

Practice Phone: 208-964-5492
Practice Fax:

Directions to “EYEMART EXPRESS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.