Provider Demographics
NPI:1063675544
Name:HOWELL VISION CENTER, INC.
Entity Type:Organization
Organization Name:HOWELL VISION CENTER, INC.
Other - Org Name:HOWELL VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CUDWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:517-545-3138
Mailing Address - Street 1:P.O. BOX 493
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48844-0493
Mailing Address - Country:US
Mailing Address - Phone:517-548-9607
Mailing Address - Fax:517-548-9609
Practice Address - Street 1:3850 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8593
Practice Address - Country:US
Practice Address - Phone:517-548-9607
Practice Address - Fax:517-548-9609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-06
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D71294OtherBLUE CROSS BLUE SHIELD
MI0D71294OtherBLUE CROSS BLUE SHIELD