Eye Clinic Of Manitowoc, S.C.
LBN: Eye Clinic Of Manitowoc, S.C.
Eye Clinic Of Manitowoc, S.C. is an health care organization with primary practice located at 4801 Expo Dr , Manitowoc WI 54220-9341. The organization recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Optician, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is the primary health care specialty.
Eye Clinic Of Manitowoc, S.C. can be contacted via phone (920) 684-4429, or through Lewellen, Donald R via phone (920) 684-4429.
Contact Information
Primary practice address
4801 Expo Dr
Manitowoc WI 54220-9341
Phone: (920) 684-4429
Fax: (920) 684-6892
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ||
| Eye and Vision Services Providers / Optician | 156FX1800X | ||
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | Wisconsin |
Profile Details
| NPI number | 1437144417 |
|---|---|
| LBN Legal business name | Eye Clinic Of Manitowoc, S.C. |
| DBA Doing business as | |
| Authorized official | Lewellen, Donald R Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Nov 19th, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437144417 | NPPES |
| Wisconsin | Other | CO8042 | RAILROAD MEDICARE |
| Wisconsin | MEDICAID | 21284400 | RAILROAD MEDICARE |
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