Summit Eye Clinic Sc

LBN: Summit Eye Clinic Sc
Summit Eye Clinic Sc is an health care organization with primary practice located at 608 East Summit Ave , Oconomowoc WI 53066-3841. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Summit Eye Clinic Sc can be contacted via phone (262) 567-6565, or through Prestash, Randy J via phone (262) 567-6565.

Contact Information

Primary practice address
608 East Summit Ave Oconomowoc WI 53066-3841
Phone: (262) 567-6565
Fax: (262) 567-8214
Website:
Map and Directions
Authorized official contact:
Name: Prestash, Randy J Doctor of Optometry (OD)
Phone: (262) 567-6565

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1780 Wisconsin

Profile Details

NPI number 1679520845
LBN Legal business name Summit Eye Clinic Sc
DBA Doing business as
Authorized official Prestash, Randy J Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2006
Last updated Mar 11th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679520845 NPPES
Wisconsin MEDICAID 38711000

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