| |
7636 Design Rd Ste 105, Baxter, MN 56425-8678 | |
(218) 825-1976 | |
(218) 828-9869 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 7636 Design Rd Ste 105, Baxter, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295914463 | NPI | - | NPPES |
566R0CR | Other | MN | BLUE PLUS DISPENSING |
CG9827 | Other | MN | PALMETTO GBA |
261527400 | Medicaid | MN | |
85038PO | Other | MN | BLUE CROSS/BLUE SHIELD MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | 2807770002 (Minnesota) | Primary |
Mailing Address | Practice Location Address |
---|---|
1 3rd Ave Ne, Crosby, MN 56441-1665 Ph: (218) 546-5108 | 7636 Design Rd Ste 105, Baxter, MN 56425-8678 Ph: (218) 825-1976 |