| |
4620 N University St, Peoria, IL 61614-5889 | |
(309) 692-8222 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Durable Medical Equipment & Medical Supplies |
Location | 4620 N University St, Peoria, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134173321 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
8309 N Knoxville Ave, Peoria, IL 61615-2170 Ph: (309) 693-9540 | 4620 N University St, Peoria, IL 61614-5889 Ph: (309) 692-8222 |