Provider Demographics
NPI:1043418510
Name:CENTRAL DAKOTA EYECARE, LLP
Entity Type:Organization
Organization Name:CENTRAL DAKOTA EYECARE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-224-6128
Mailing Address - Street 1:640 E SIOUX AVE
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-3300
Mailing Address - Country:US
Mailing Address - Phone:605-224-6128
Mailing Address - Fax:605-224-8446
Practice Address - Street 1:640 E SIOUX AVE
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3300
Practice Address - Country:US
Practice Address - Phone:605-224-6128
Practice Address - Fax:605-224-8446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0572650001Medicare NSC
SDS40136Medicare PIN