1215945092 NPI number — ASSOCIATED EYE CARE OPTICAL LLC

Table of content: DR. DARREN ALLEN WINKLER DPM (NPI 1710966403)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215945092 NPI number — ASSOCIATED EYE CARE OPTICAL LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATED EYE CARE OPTICAL LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215945092
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1719 TOWER DR W STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STILLWATER
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55082-7512
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-275-3000
Provider Business Mailing Address Fax Number:
651-275-3027

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1625 RADIO DR
Provider Second Line Business Practice Location Address:
SUITE 310
Provider Business Practice Location Address City Name:
WOODBURY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55125-9407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-275-3000
Provider Business Practice Location Address Fax Number:
651-275-3027
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LANE
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
651-275-3000

Provider Taxonomy Codes

  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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