The Waupun Eye Clinic

LBN: Vita Park Eye Associates, Sc
The Waupun Eye Clinic is an health care organization with primary practice located at 140 Gateway Dr , Waupun WI 53963-2276. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology. Eye and Vision Services Providers / Optometrist is the primary health care specialty. Vita Park Eye Associates, Sc can be contacted via phone (920) 324-3191, or through Castillo, Thomas via phone (920) 887-1151.

Contact Information

Primary practice address
140 Gateway Dr Waupun WI 53963-2276
Phone: (920) 324-3191
Fax: (920) 324-5026
Website:
Map and Directions
Authorized official contact:
Name: Castillo, Thomas Doctor of Osteopathy (DO)
Phone: (920) 887-1151

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X

Profile Details

NPI number 1548286909
LBN Legal business name Vita Park Eye Associates, Sc
DBA Doing business as The Waupun Eye Clinic
Authorized official Castillo, Thomas Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 15th, 2006
Last updated Apr 21st, 2021 - about 5 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 1548286909 NPPES
Other 530337 DEANCARE HMO LOCATION
Other 000016160 DEANCARE HMO LOCATION
Other CP765 DEANCARE HMO LOCATION
MEDICAID 21310700 DEANCARE HMO LOCATION
Other 0593830001 DEANCARE HMO LOCATION

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