Superior Vision, Llc | |
10922 E County Road 800 S Ste A Camby IN 46113-9161 | |
(317) 856-2000 | |
(317) 865-2000 |
Full Name | Superior Vision, Llc |
---|---|
Speciality | Clinic/Center |
Location | 10922 E County Road 800 S Ste A, Camby, Indiana |
Authorized Official Name and Position | Dianne E Porter (O.D./PRESIDENT) |
Authorized Official Contact | 8123204362 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Superior Vision, Llc 8190 Windfall Ln Ste C Camby IN 46113-7906 Ph: (317) 856-2000 | Superior Vision, Llc 10922 E County Road 800 S Ste A Camby IN 46113-9161 Ph: (317) 856-2000 |
NPI Number | 1083890172 |
---|---|
Provider Enumeration Date | 01/18/2008 |
Last Update Date | 11/11/2019 |
Medicare PECOS PAC ID | 5597948505 |
---|---|
Medicare Enrollment ID | O20110329000947 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083890172 | NPI | - | NPPES |
200893590 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 18002637B (Indiana) | Primary |
Provider Name | Dianne Elizabeth Porter |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1467587055 PECOS PAC ID: 6406039411 Enrollment ID: I20110329000956 |
Provider Name | Lauren Marie Gardner |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1912437369 PECOS PAC ID: 2769752401 Enrollment ID: I20170727003897 |
Heartland Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10701 Alliance Dr, Camby, IN 46113 Phone: 317-856-7083 Fax: 317-856-7332 |