| |
902 E Locust St, Olney, IL 62450-2586 | |
(618) 392-2020 | |
(618) 392-0646 |
Full Name | |
---|---|
Type | Facility |
Speciality | Durable Medical Equipment & Medical Supplies |
Location | 902 E Locust St, Olney, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508293069 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Illinois) | Secondary |
207W00000X | Ophthalmology | (Illinois) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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1200 W Deyoung St, Marion, IL 62959-4437 Ph: (618) 969-8777 | 902 E Locust St, Olney, IL 62450-2586 Ph: (618) 392-2020 |