Gillette Optometric Clinic Pc
LBN: Gillette Optometric Clinic Pc
Gillette Optometric Clinic Pc is an health care organization with primary practice located at 609 4J Ct , Gillette WY 82716-4135. The organization recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Corneal and Contact Management is the primary health care specialty.
Gillette Optometric Clinic Pc can be contacted via phone (307) 682-2020, or through Jordan, Roger L via phone (307) 682-2020.
Contact Information
Primary practice address
609 4J Ct
Gillette WY 82716-4135
Phone: (307) 682-2020
Fax: (307) 682-5656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 93-T | Wyoming |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 142-T | Wyoming |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 288-T | Wyoming |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 263-T | Wyoming |
Profile Details
| NPI number | 1891850707 |
|---|---|
| LBN Legal business name | Gillette Optometric Clinic Pc |
| DBA Doing business as | |
| Authorized official | Jordan, Roger L Doctor of Optometry (OD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 22nd, 2006 |
| Last updated | Apr 13th, 2010 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891850707 | NPPES |
| Wyoming | MEDICAID | 103952100 | |
| Wyoming | Other | 1659399376 | |
| Wyoming | Other | 1972537561 | |
| Wyoming | Other | 1023035854 | |
| Wyoming | MEDICAID | 103718800 | |
| Wyoming | MEDICAID | 11504720 | |
| Wyoming | MEDICAID | 11903420 | |
| Wyoming | Other | 1265466320 |
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