Custom Eyes

LBN: Pam Ebert Od Llc
Custom Eyes is an health care organization with primary practice located at 1871 2Nd St , Springfield OR 97477-2121. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Pam Ebert Od Llc can be contacted via phone (541) 741-0122, or through Ebert, Pam via phone (541) 741-0122.

Contact Information

Primary practice address
1871 2Nd St Springfield OR 97477-2121
Phone: (541) 741-0122
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ebert, Pam Doctor of Optometry (OD)
Phone: (541) 741-0122

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 3484AT Oregon

Profile Details

NPI number 1750650131
LBN Legal business name Pam Ebert Od Llc
DBA Doing business as Custom Eyes
Authorized official Ebert, Pam Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2011
Last updated Jun 29th, 2015 - about 10 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 1750650131 NPPES
Oregon Other R174133 PTAN

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