| |
43500 Migizi Dr, Onamia, MN 56359-2241 | |
(320) 532-4163 | |
(320) 532-4354 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 43500 Migizi Dr, Onamia, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285813451 | NPI | - | NPPES |
261527400 | Medicaid | MN | |
CG9827 | Other | MN | PALMETTO GBA |
566R0CR | Other | MN | BLUE PLUS DISP |
85038PO | Other | MN | BLUE CROSS/BLUE SHIELD MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | 2807770001 (Minnesota) | Primary |
Mailing Address | Practice Location Address |
---|---|
1 3rd Ave Ne, Crosby, MN 56441-1665 Ph: (218) 546-5108 | 43500 Migizi Dr, Onamia, MN 56359-2241 Ph: (320) 532-4163 |