1932218120 NPI number — MEYER FAMILY VISION, P.C.

Table of content: (NPI 1932218120)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932218120 NPI number — MEYER FAMILY VISION, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEYER FAMILY VISION, 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:
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:
1932218120
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1366 US HIGHWAY 41 W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ISHPEMING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49849-3152
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
906-485-1300
Provider Business Mailing Address Fax Number:
906-485-4040

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1366 US HIGHWAY 41 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ISHPEMING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49849-3152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
906-485-1300
Provider Business Practice Location Address Fax Number:
906-485-4040
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MEYER
Authorized Official First Name:
SARA
Authorized Official Middle Name:
BETH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
906-485-1300

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  4901003638 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 4901003639 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152W00000X , with the licence number: 4901004069 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2892426 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 900E263450 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 2892373 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4271315 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0E26345 . This is a "MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: CN2333 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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