| |
119 N Springfield St, Virden, IL 62690-1455 | |
(217) 965-3306 | |
(217) 965-3679 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 119 N Springfield St, Virden, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336265875 | NPI | - | NPPES |
410042503 | Other | IL | HEDRICK RAILRAOD MEDICARE |
046006408 | Medicaid | IL | |
0001115000 | Other | IL | BC BS GROUP NUMBER |
046008125 | Medicaid | IL | |
410042688 | Other | IL | RUBRICH RAILRAOD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 046008125 (Illinois) | Primary |
152W00000X | Optometrist | 046006408 (Illinois) | Secondary |
Mailing Address | Practice Location Address |
---|---|
119 N Springfield St, Virden, IL 62690-1455 Ph: (217) 965-3306 | 119 N Springfield St, Virden, IL 62690-1455 Ph: (217) 965-3306 |