Provider Demographics
NPI:1467927525
Name:DRAMEN EYECARE, LLC
Entity Type:Organization
Organization Name:DRAMEN EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DRAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:763-772-5514
Mailing Address - Street 1:3144 CHOWEN AVE S APT 118
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5446
Mailing Address - Country:US
Mailing Address - Phone:763-772-5514
Mailing Address - Fax:
Practice Address - Street 1:1360 TOWN CENTRE DR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-2310
Practice Address - Country:US
Practice Address - Phone:651-686-7435
Practice Address - Fax:651-686-7438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty