Antigo Eye Care Center

LBN: Antigo Eye Care Center
Antigo Eye Care Center is an health care organization with primary practice located at 810 5Th Ave , Antigo WI 54409-1937. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Antigo Eye Care Center can be contacted via phone (715) 623-3620, or through Bartlette, Mary Kay via phone (715) 623-3620.

Contact Information

Primary practice address
810 5Th Ave Antigo WI 54409-1937
Phone: (715) 623-3620
Fax: (715) 623-3333
Website:
Map and Directions
Authorized official contact:
Name: Bartlette, Mary Kay
Phone: (715) 623-3620

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X T61453 Wisconsin

Profile Details

NPI number 1457459836
LBN Legal business name Antigo Eye Care Center
DBA Doing business as
Authorized official Bartlette, Mary Kay
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2006
Last updated Jul 10th, 2008 - about 18 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 1457459836 NPPES
Wisconsin MEDICAID 38708600-38553700

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