Maple Grove Eye Clinic
LBN: G.R. Thomas Jr Od Pa
Maple Grove Eye Clinic is an health care organization with primary practice located at 7880 Mainstreet , Maple Grove MN 55369-7081. 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). Suppliers / Eyewear Supplier (Equipment, not the service) is the primary health care specialty.
G.R. Thomas Jr Od Pa can be contacted via phone (763) 420-6981, or through Lindstrom, Alissa via phone (763) 420-6981.
Contact Information
Primary practice address
7880 Mainstreet
Maple Grove MN 55369-7081
Phone: (763) 420-6981
Fax: (763) 773-7253
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1457 | Minnesota |
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X |
Profile Details
| NPI number | 1659556264 |
|---|---|
| LBN Legal business name | G.R. Thomas Jr Od Pa |
| DBA Doing business as | Maple Grove Eye Clinic |
| Authorized official | Lindstrom, Alissa CPO |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 2nd, 2008 |
| Last updated | Mar 4th, 2011 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659556264 | NPPES |
| Minnesota | MEDICAID | 652323400 |
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