Provider Demographics
NPI:1225219744
Name:NAPOLEON FAMILY VISION AND CONTACT LENS CENTER, LLC
Entity Type:Organization
Organization Name:NAPOLEON FAMILY VISION AND CONTACT LENS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOSTELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-599-4541
Mailing Address - Street 1:1804 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-9242
Mailing Address - Country:US
Mailing Address - Phone:419-599-4541
Mailing Address - Fax:
Practice Address - Street 1:1804 OAKWOOD AVE.
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-9677
Practice Address - Country:US
Practice Address - Phone:419-599-4541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5702152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2901499Medicaid
OH2901499Medicaid
6130810001Medicare NSC