Audubon Optical Shop

LBN: Retina Associates, Psc
Audubon Optical Shop is an health care organization with primary practice located at 2355 Poplar Level Rd , Louisville KY 40217-1395. The organization recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as the primary health care specialty. Retina Associates, Psc can be contacted via phone (502) 637-3036, or through Prussian, Mark M via phone (502) 589-1500.

Contact Information

Primary practice address
2355 Poplar Level Rd Louisville KY 40217-1395
Phone: (502) 637-3036
Fax: (502) 637-1105
Website:
Map and Directions
Authorized official contact:
Name: Prussian, Mark M
Phone: (502) 589-1500

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X

Profile Details

NPI number 1679626139
LBN Legal business name Retina Associates, Psc
DBA Doing business as Audubon Optical Shop
Authorized official Prussian, Mark M
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2007
Last updated Jun 29th, 2009 - about 15 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 1679626139 NPPES
Indiana MEDICAID 100221560
Indiana MEDICAID 65917502

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