Enchanted Mountain Eyecare

LBN: Enchanted Mountain Optometry,Pllc
Enchanted Mountain Eyecare is an health care organization with primary practice located at 912 W State St , Olean NY 14760-2242. The organization recently has only one registered license in Suppliers / Eyewear Supplier (Equipment, not the service), which is considered as the primary health care specialty. Enchanted Mountain Optometry,Pllc can be contacted via phone (716) 373-0766, or through Ludden, Tracy L via phone (716) 373-0766.

Contact Information

Primary practice address
912 W State St Olean NY 14760-2242
Phone: (716) 373-0766
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ludden, Tracy L Doctor of Optometry (OD)
Phone: (716) 373-0766

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X T005716 New York

Profile Details

NPI number 1013294685
LBN Legal business name Enchanted Mountain Optometry,Pllc
DBA Doing business as Enchanted Mountain Eyecare
Authorized official Ludden, Tracy L Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 10th, 2011
Last updated Nov 10th, 2011 - 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 1013294685 NPPES
New York MEDICAID 01608566

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