Provider Demographics
NPI:1366443145
Name:OCU LABS INC
Entity Type:Organization
Organization Name:OCU LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:JOKINEN
Authorized Official - Suffix:
Authorized Official - Credentials:OCULARIST
Authorized Official - Phone:952-854-6702
Mailing Address - Street 1:7851 METRO PKWY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1567
Mailing Address - Country:US
Mailing Address - Phone:952-854-6702
Mailing Address - Fax:952-854-0761
Practice Address - Street 1:7851 METRO PKWY
Practice Address - Street 2:SUITE 225
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1567
Practice Address - Country:US
Practice Address - Phone:952-854-6702
Practice Address - Fax:952-854-0761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN378-363-400Medicaid
MN38492OCOtherBC BS MN
MN106082OtherU CARE
MN82-90210OtherMEDICA
MN0182140001Medicare NSC