| Coquille Vision Center | |
|
855 W Central St, Coquille, OR 97423-1290 | |
| (541) 396-4042 | |
| Not Available |
| Full Name | Coquille Vision Center |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 855 W Central St, Coquille, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508069428 | NPI | - | NPPES |
| 287017 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2856ATI (Oregon) | Primary |
| Provider Name | Nicole Rush |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467400952 PECOS PAC ID: 5799779971 Enrollment ID: I20100428000417 |
| Provider Name | John Benjamin Rush |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568483147 PECOS PAC ID: 9032122668 Enrollment ID: I20101021000886 |
| Provider Name | Morgan Josie Grove |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598114340 PECOS PAC ID: 3678860723 Enrollment ID: I20161122002444 |
| Provider Name | Ashley Nicole Calvert |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104486356 PECOS PAC ID: 4486981867 Enrollment ID: I20190903001935 |
| Mailing Address | Practice Location Address |
|---|---|
| Coquille Vision Center Po Box 489, Coquille, OR 97423-0489 Ph: (541) 396-4042 | Coquille Vision Center 855 W Central St, Coquille, OR 97423-1290 Ph: (541) 396-4042 |
Dr. John Paul Reslock, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 855 W Central St, Coquille, OR 97423 Phone: 541-396-4042 Fax: 541-396-6507 | |
Morgan Grove, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 855 W Central Blvd Ste A, Coquille, OR 97423 Phone: 541-396-4042 |