Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 14 2nd St Ne, Bagley, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558350678 | NPI | - | NPPES |
137823600 | Medicaid | MN | |
2224062 | Other | MN | MEDICA |
2100013 | Other | MN | MEDICA |
410027728 | Other | MN | MEDICARE RAILROAD |
82043NE | Other | MN | BLUE PLUS |
08298 | Other | MN | METRO HEALTH |
42B91NE | Other | MN | BLUE PLUS OPTICAL |
83340NE | Other | MN | BLUE PLUS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1892 (Minnesota) | Primary |
Mailing Address | Practice Location Address |
---|---|
Po Box J, 14 2nd St Ne, Bagley, MN 56621-1008 Ph: (218) 694-2442 | 14 2nd St Ne, Bagley, MN 56621 Ph: (218) 694-2442 |