Organization Name: | CEDAR RUN EYE CENTER-BEULAH OPTICAL |
NPI Number: | 1942420096 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER GROCHOWALSKI (ADMINISTRATION) |
Mailing Address: | 3830 W Front St Traverse City |
State: | MI US |
Postal Code: | 496848153 |
Phone Number: | 2319293888 |
Fax Number: | 2319294365 |
NPI Enumeration Date: | 04/30/2007 |
NPI Last Update Date: | 11/05/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |