Tillman Optometry Llc
LBN: Tillman Optometry Llc
Tillman Optometry Llc is an health care organization with primary practice located at 2304 S Main St , Rice Lake WI 54868-2900. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Suppliers / Eyewear Supplier (Equipment, not the service). Suppliers / Eyewear Supplier (Equipment, not the service) is the primary health care specialty.
Tillman Optometry Llc can be contacted via phone (715) 736-1700, or through Tillman, Robert E via phone (715) 736-1700.
Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ||
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X |
Profile Details
| NPI number | 1538142989 |
|---|---|
| LBN Legal business name | Tillman Optometry Llc |
| DBA Doing business as | |
| Authorized official | Tillman, Robert E Doctor of Optometry (OD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 21st, 2005 |
| Last updated | Feb 20th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538142989 | NPPES |
| Wisconsin | Other | 130004329 | WEA |
| Wisconsin | MEDICAID | 38563500 | WEA |
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