| |
4902 Indianapolis Blvd, East Chicago, IN 46312-3605 | |
(219) 398-2066 | |
(219) 398-2066 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 4902 Indianapolis Blvd, East Chicago, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700909884 | NPI | - | NPPES |
100215150D | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
---|---|
4902 Indianapolis Blvd, East Chicago, IN 46312-3605 Ph: (219) 398-2066 | 4902 Indianapolis Blvd, East Chicago, IN 46312-3605 Ph: (219) 398-2066 |
Khushbu Mehta, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2323 Broadway Street, East Chicago, IN 46312 Phone: 219-354-8910 Fax: 219-354-0900 |