Provider Demographics
NPI:1326159476
Name:OPTOMETRY 2000 VISION CARE INC
Entity Type:Organization
Organization Name:OPTOMETRY 2000 VISION CARE INC
Other - Org Name:ALBANY EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:GROETSCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:320-845-4747
Mailing Address - Street 1:471 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:MN
Mailing Address - Zip Code:56307-9458
Mailing Address - Country:US
Mailing Address - Phone:320-845-4747
Mailing Address - Fax:320-845-4885
Practice Address - Street 1:471 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:MN
Practice Address - Zip Code:56307-9458
Practice Address - Country:US
Practice Address - Phone:320-845-4747
Practice Address - Fax:320-845-4885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN2082152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN115186OtherUCARE PROV. NUMBER
MN5C705GROtherBLUE PLUS MATERIAL PROV.
MN21-00018OtherMEDICA MATERIALS PROV. NU
MN380225600Medicaid
MN47576OtherHEALTHPARTNERS PROV. NUM
MN1006663OtherPREFERRED ONE PROV. NUM
MNMN2082OtherEYEMED PROV. NUMBER
MN410031767OtherRAILROAD MEDICARE PROV.
MNT92312Medicare UPIN
MN115186OtherUCARE PROV. NUMBER