Beaverton Family Eyecare

LBN: Dr. Dale J Moser Od
Beaverton Family Eyecare is an health care organization with primary practice located at 334 N Ross , Beaverton MI 48612. 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. Dr. Dale J Moser Od can be contacted via phone (989) 435-2020, or through Moser, Dale James via phone (989) 386-2020.

Contact Information

Primary practice address
334 N Ross Beaverton MI 48612
Phone: (989) 435-2020
Fax: (989) 435-2554
Website:
Map and Directions
Authorized official contact:
Name: Moser, Dale James Doctor of Optometry (OD)
Phone: (989) 386-2020

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901003085 Michigan
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X 003085 Michigan
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X 004640 Michigan

Profile Details

NPI number 1477738961
LBN Legal business name Dr. Dale J Moser Od
DBA Doing business as Beaverton Family Eyecare
Authorized official Moser, Dale James Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 3rd, 2008
Last updated Apr 3rd, 2012 - about 13 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 1477738961 NPPES
Michigan Other 900A86500 BC/BS
Michigan MEDICAID 1908862 BC/BS
Michigan Other 410008233 BC/BS

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