Provider Demographics
NPI:1396820494
Name:SMEELINK ACQUISITIONS INC
Entity Type:Organization
Organization Name:SMEELINK ACQUISITIONS INC
Other - Org Name:CO OP OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WESTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-846-0620
Mailing Address - Street 1:105 W EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-2024
Mailing Address - Country:US
Mailing Address - Phone:616-846-0620
Mailing Address - Fax:616-844-6079
Practice Address - Street 1:2897 RADCLIFF AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49512-1793
Practice Address - Country:US
Practice Address - Phone:616-942-2710
Practice Address - Fax:616-942-8680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7951OtherCOOP VISION DESIGNS INS
MI7951OtherCOOP VISION DESIGNS INS
MIP21400005Medicare ID - Type UnspecifiedMEDICARE DOCTOR NUMBER
MI5472600013Medicare NSC
MI=========OtherTAX ID
MIT33036Medicare UPIN
MIU57963Medicare UPIN
MIP21400002Medicare ID - Type UnspecifiedMEDICARE DOCTOR NUMBER
MIP21400007Medicare PIN
MIT12060Medicare UPIN
MIP00296092Medicare ID - Type UnspecifiedRAILROAD MEDICARE DOCTOR