Provider Demographics
NPI:1407059389
Name:MUNSTER EYE CARE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:MUNSTER EYE CARE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BINH
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-922-6226
Mailing Address - Street 1:759 45TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2938
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:759 45TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2938
Practice Address - Country:US
Practice Address - Phone:219-922-6226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MUNSTER EYE CARE ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-07
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200919870AOtherMEDICAID DME
IN200919870AOtherMEDICAID DME