| |
801 Huntington Ave, Warren, IN 46792-9402 | |
(888) 664-6148 | |
(260) 569-9264 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 801 Huntington Ave, Warren, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124155452 | NPI | - | NPPES |
200289790B | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 56000164A (Indiana) | Primary |
Mailing Address | Practice Location Address |
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Po Box 527, Wabash, IN 46992-0527 Ph: (888) 664-6148 | 801 Huntington Ave, Warren, IN 46792-9402 Ph: (888) 664-6148 |