Guthrie Vision Source Pc, Inc.

LBN: Guthrie Vision Source Pc, Inc.
Guthrie Vision Source Pc, Inc. is an health care organization with primary practice located at 110 E Harrison Ave , Guthrie OK 73044-4839. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Suppliers / Eyewear Supplier (Equipment, not the service). Eye and Vision Services Providers / Optometrist is the primary health care specialty. Guthrie Vision Source Pc, Inc. can be contacted via phone (405) 282-4396, or through Bennett, Michael E. via phone (405) 282-4396.

Contact Information

Primary practice address
110 E Harrison Ave Guthrie OK 73044-4839
Fax: (405) 282-8298
Website:
Authorized official contact:
Name: Bennett, Michael E. Doctor of Optometry (OD)

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X Oklahoma
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X Oklahoma

Profile Details

NPI number 1982625703
LBN Legal business name Guthrie Vision Source Pc, Inc.
DBA Doing business as
Authorized official Bennett, Michael E. Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 21st, 2006
Last updated Feb 4th, 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 1982625703 NPPES
Oklahoma Other DC6377 RR MEDICARE
Oklahoma MEDICAID 100759960A RR MEDICARE

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