Lakeside Vision Inc

LBN: Lakeside Vision Inc
Lakeside Vision Inc is an health care organization with primary practice located at 888 W Houghton Lake Dr , Prudenville MI 48651-9451. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Lakeside Vision Inc can be contacted via phone (989) 366-7525, or through Boggs, Jennifer via phone (989) 366-7525.

Contact Information

Primary practice address
888 W Houghton Lake Dr Prudenville MI 48651-9451
Phone: (989) 366-7525
Fax: (989) 366-5405
Website:
Map and Directions
Authorized official contact:
Name: Boggs, Jennifer
Phone: (989) 366-7525

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X MI2953 Michigan

Profile Details

NPI number 1790789550
LBN Legal business name Lakeside Vision Inc
DBA Doing business as
Authorized official Boggs, Jennifer
Entity Organization
Organization subpart 1 No
Enumeration date Jun 9th, 2005
Last updated Jul 16th, 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 1790789550 NPPES
Michigan MEDICAID 1562533
Michigan Other 900G21001

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