Sullivan Eye Center, S.c. is a
Ophthalmology based in Appleton, Wisconsin. Sullivan Eye Center, S.c. is licensed to practice in Wisconsin (license number 18799) and their current practice location is
1195 N Casaloma Dr, Appleton, Wisconsin. It can be reached at their office (for appointments etc.) via phone at
(920) 734-0400.
NPI number for Sullivan Eye Center, S.c. is 1104919869 and their current mailing address is 1195 N Casaloma Dr, Appleton, Wisconsin. Sullivan Eye Center, S.c.
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1104919869.
Healthcare Provider's Profile
| Full Name | Sullivan Eye Center, S.c. |
|---|
| Type | Facility |
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| Speciality | Ophthalmology |
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| Location | 1195 N Casaloma Dr, Appleton, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1104919869
- Provider Enumeration Date: 10/02/2006
- Last Update Date: 09/03/2008
Medical Identifiers
Medical identifiers for Sullivan Eye Center, S.c. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104919869 | NPI | - | NPPES |
| 38455900 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 2483-035 (Wisconsin) | Secondary |
| 152W00000X | Optometrist | 2752-035 (Wisconsin) | Secondary |
| 152W00000X | Optometrist | 2681-035 (Wisconsin) | Secondary |
| 207W00000X | Ophthalmology | 18799 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sullivan Eye Center, S.c. is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Sullivan Eye Center, S.c.
1195 N Casaloma Dr,
Appleton, WI 54913-9295
Ph: (920) 734-0400 | Sullivan Eye Center, S.c.
1195 N Casaloma Dr,
Appleton, WI 54913-9295
Ph: (920) 734-0400 |
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