St Croix Vision Center Inc.

LBN: St Croix Vision Center Inc.
St Croix Vision Center Inc. is an health care organization with primary practice located at 13481 60Th St N Suite 200, Stillwater MN 55082-1055. The organization recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Optometrist is the primary health care specialty. St Croix Vision Center Inc. can be contacted via phone (651) 439-6400, or through Johnson, Travis Matthew via phone (651) 439-6400.

Contact Information

Primary practice address
13481 60Th St N Suite 200 Stillwater MN 55082-1055
Phone: (651) 439-6400
Fax: (651) 439-6405
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Travis Matthew Doctor of Optometry (OD)
Phone: (651) 439-6400

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X LD2763000 Minnesota
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X LD2763000 Minnesota
Eye and Vision Services Providers / Pediatrics 152WP0200X LD2763000
Eye and Vision Services Providers / Vision Therapy 152WV0400X LD2763000 Minnesota

Profile Details

NPI number 1518059526
LBN Legal business name St Croix Vision Center Inc.
DBA Doing business as
Authorized official Johnson, Travis Matthew Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 28th, 2006
Last updated Aug 16th, 2012 - about 14 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 1518059526 NPPES
Minnesota Other 108J4JO BLUE CROSS BLUE SHEILD GR
Minnesota MEDICAID 904623200 BLUE CROSS BLUE SHEILD GR

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