| |
401 Buster Rd, Toppenish, WA 98948-9792 | |
(509) 865-2102 | |
(509) 865-2102 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 401 Buster Rd, Toppenish, Washington |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376681452 | NPI | - | NPPES |
51239 | Other | WA | LABOR & INDUSTRY RX # |
4926311 | Other | WA | NATL ASSN BD PHARM |
21940 | Other | WA | LABOR & INDUSTRY MED # |
7100506 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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401 Buster Rd, Toppenish, WA 98948-9792 Ph: (509) 865-2102 | 401 Buster Rd, Toppenish, WA 98948-9792 Ph: (509) 865-2102 |
Gustavo Rodriguez, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 510 W 1st Ave Unit 934, Toppenish, WA 98948 Phone: 509-865-0800 Fax: 509-865-2904 |