1235230350 NPI number — RAPIDS OPHTHALMOLOGY, P.C.

Table of content: (NPI 1235230350)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235230350 NPI number — RAPIDS OPHTHALMOLOGY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAPIDS OPHTHALMOLOGY, P.C.
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:
6
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:
1235230350
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
650 LINDEN ST
Provider Second Line Business Mailing Address:
SUITE 5
Provider Business Mailing Address City Name:
BIG RAPIDS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49307-1880
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-796-0010
Provider Business Mailing Address Fax Number:
231-796-2496

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
650 LINDEN ST
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
BIG RAPIDS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-796-0010
Provider Business Practice Location Address Fax Number:
231-796-2496
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EICHLER
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
231-796-0010

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 180036284 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: CG0293 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0E40038 . This is a "BCBSM - OPTOMETRISTS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1235230350 . This is a "COMMERCIAL INSURERS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0E41065 . This is a "BCBSM - OPHTHALMOLOGISTS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1280290002 . This is a "MEDICARE NSC - HOWARD CITY" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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