Maloney'S Custom Ocular Prosthetics, Inc.

LBN: Maloney'S Custom Ocular Prosthetics, Inc.
Maloney'S Custom Ocular Prosthetics, Inc. is an health care organization with primary practice located at 4035 Mercantile Dr Ste 208 , Lake Oswego OR 97035-2591. The organization recently has only one registered license in Eye and Vision Services Providers / Ocularist, which is considered as the primary health care specialty. Maloney'S Custom Ocular Prosthetics, Inc. can be contacted via phone (503) 675-1320, or through Schou, Kevin via phone (503) 675-1320.

Contact Information

Primary practice address
4035 Mercantile Dr Ste 208 Lake Oswego OR 97035-2591
Phone: (503) 675-1320
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Schou, Kevin
Phone: (503) 675-1320

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Ocularist 156FX1700X 2002801 Oregon

Profile Details

NPI number 1043360977
LBN Legal business name Maloney'S Custom Ocular Prosthetics, Inc.
DBA Doing business as
Authorized official Schou, Kevin
Entity Organization
Organization subpart 1 No
Enumeration date Jan 11th, 2007
Last updated Jun 26th, 2012 - about 12 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 1043360977 NPPES
Oregon MEDICAID 125096

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