Provider Demographics
NPI:1477683407
Name:ZIGULIS EYE CARE INC.
Entity Type:Organization
Organization Name:ZIGULIS EYE CARE INC.
Other - Org Name:BEDFORD EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ZIGULIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:734-856-7070
Mailing Address - Street 1:3409 STERNS RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9576
Mailing Address - Country:US
Mailing Address - Phone:734-856-7070
Mailing Address - Fax:734-856-2092
Practice Address - Street 1:3409 STERNS RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9576
Practice Address - Country:US
Practice Address - Phone:734-856-7070
Practice Address - Fax:734-856-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003971152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4490035Medicaid
MI4704946Medicaid
MI4704946Medicaid
4714510001Medicare NSC
MI4490035Medicaid