Fond Du Lac Regional Optical

LBN: Agnesian Healthcare Inc
Fond Du Lac Regional Optical is an health care organization with primary practice located at 421 Camelot Dr , Fond Du Lac WI 54935-8335. The organization recently has only one registered license in Suppliers / Eyewear Supplier (Equipment, not the service), which is considered as the primary health care specialty. Agnesian Healthcare Inc can be contacted via phone (920) 926-8316, or through Grinnell, Amy Jo via phone (608) 260-3586.

Contact Information

Primary practice address
421 Camelot Dr Fond Du Lac WI 54935-8335
Phone: (920) 926-8316
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Grinnell, Amy Jo
Phone: (608) 260-3586

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X

Profile Details

NPI number 1154595387
LBN Legal business name Agnesian Healthcare Inc
DBA Doing business as Fond Du Lac Regional Optical
Authorized official Grinnell, Amy Jo
Entity Organization
Organization subpart 1 No
Enumeration date Apr 18th, 2008
Last updated Jun 5th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154595387 NPPES
Wisconsin MEDICAID 38437100

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