Provider Demographics
NPI:1861609075
Name:BARNETT VISION CENTER LLP
Entity type:Organization
Organization Name:BARNETT VISION CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:L
Authorized Official - Last Name:REMILY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-225-4046
Mailing Address - Street 1:508 MOCCASIN DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-5059
Mailing Address - Country:US
Mailing Address - Phone:605-225-4046
Mailing Address - Fax:605-225-9728
Practice Address - Street 1:508 MOCCASIN DR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-5059
Practice Address - Country:US
Practice Address - Phone:605-225-4046
Practice Address - Fax:605-225-9728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDT544152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS6851OtherMEDICARE ID
SDCG6218OtherRAILROAD MEDICARE
SD1315120001Medicare NSC