Birch Lake Eye Clinic, Oak Tree Optical, Village Eye Clinic And Optica

LBN: Birch Lake Vision Group, Llc.
Birch Lake Eye Clinic, Oak Tree Optical, Village Eye Clinic And Optica is an health care organization with primary practice located at 4720 White Bear Pkwy , White Bear Lake MN 55110-3336. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Birch Lake Vision Group, Llc. can be contacted via phone (651) 426-2747, or through Grudem, Brian Dwight via phone (651) 426-2747.

Contact Information

Primary practice address
4720 White Bear Pkwy White Bear Lake MN 55110-3336
Phone: (651) 426-2747
Fax: (651) 426-9838
Website:
Map and Directions
Authorized official contact:
Name: Grudem, Brian Dwight Doctor of Optometry (OD)
Phone: (651) 426-2747

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X LD1732000 Minnesota
Eye and Vision Services Providers / Optometrist 152W00000X LD2695000 Minnesota

Profile Details

NPI number 1609921899
LBN Legal business name Birch Lake Vision Group, Llc.
DBA Doing business as Birch Lake Eye Clinic, Oak Tree Optical, Village Eye Clinic And Optica
Authorized official Grudem, Brian Dwight Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 25th, 2007
Last updated Dec 2nd, 2009 - about 15 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 1609921899 NPPES
Minnesota Other 22-01733 MEDICA (BIRCH LAKE)
Minnesota Other 244ROLU MEDICA (BIRCH LAKE)
Minnesota Other P00116310 MEDICA (BIRCH LAKE)
Minnesota Other P00124841 MEDICA (BIRCH LAKE)
Minnesota Other 22-02690 MEDICA (BIRCH LAKE)
Minnesota Other 965401019270 MEDICA (BIRCH LAKE)
Minnesota Other 22-02779 MEDICA (BIRCH LAKE)
Minnesota Other HP29577 MEDICA (BIRCH LAKE)
Minnesota Other ON456GR MEDICA (BIRCH LAKE)
Minnesota Other 22-02780 MEDICA (BIRCH LAKE)
Minnesota Other 965400656001 MEDICA (BIRCH LAKE)
Minnesota Other HP27080 MEDICA (BIRCH LAKE)

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