| Nico Rouse Corporation Pc | |
|
5800 Westover Ave, Elmendorf Afb, AK 99506-1603 | |
| (907) 753-7515 | |
| (907) 753-7585 |
| Full Name | Nico Rouse Corporation Pc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 5800 Westover Ave, Elmendorf Afb, Alaska |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023182821 | NPI | - | NPPES |
| DE9528 | Other | MEDICARE RAILROAD GROUP # | |
| 3183314 | Other | AETNA HMO | |
| P00327511 | Other | MEDICARE RAILROAD | |
| 7283193 | Other | AETNA PPO | |
| OD2260 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 226 (Alaska) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Nico Rouse Corporation Pc 9321 Milburn Loop Se, Lacey, WA 98513-3420 Ph: () - | Nico Rouse Corporation Pc 5800 Westover Ave, Elmendorf Afb, AK 99506-1603 Ph: (907) 753-7515 |
Dr. Ronald Michael Kichura, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 5955 Zeamer Ave, 3 Mdg Optometry Clinic, Elmendorf Afb, AK 99506 Phone: 907-580-1150 Fax: 907-580-1152 | |
Nathaniel Arthur Foster, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 673 Medical Group, 5955 Zeamer Ave, Elmendorf Afb, AK 99506 Phone: 907-580-0276 |