Fennewald, Wilfred James
Fennewald, Wilfred James is an sole proprietor health care provider with primary practice located at 2737 Navarre Ave Ste 204 , Oregon OH 43616-3276. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Contact Lens Fitter, Eye and Vision Services Providers / Optician. Eye and Vision Services Providers / Optician is his primary health care specialty. Fennewald, Wilfred James can be contacted via phone (419) 693-3376.Contact Information
Primary practice address
2737 Navarre Ave Ste 204
Oregon OH 43616-3276
Phone: (419) 693-3376
Fax: (419) 693-7519
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Contact Lens Fitter | 156FC0801X | SC2077 | Ohio |
| Eye and Vision Services Providers / Optician | 156FX1800X | SC2077 | Ohio |
Profile Details
| NPI number | 1093790941 |
|---|---|
| LBN Legal business name | Fennewald, Wilfred James |
| Credentials | LICENSED OPTICIAN |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2005 |
| Last updated | Jan 28th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093790941 | NPPES |
| Ohio | Other | 363492 | NVA |
| Ohio | Other | OH2077 | NVA |
| Ohio | MEDICAID | 0511637 | NVA |
| Ohio | Other | 31106091100 | NVA |
| Ohio | Other | 000000155056 | NVA |
| Ohio | Other | 10251 | NVA |
| Ohio | Other | 311060911001 | NVA |
| Ohio | Other | 15295 | NVA |
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