Provider Demographics
NPI:1598825549
Name:VERONA VISION CARE, LLC
Entity Type:Organization
Organization Name:VERONA VISION CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:608-848-5168
Mailing Address - Street 1:301 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1494
Mailing Address - Country:US
Mailing Address - Phone:608-848-5168
Mailing Address - Fax:608-848-6012
Practice Address - Street 1:320 S MAIN ST
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1424
Practice Address - Country:US
Practice Address - Phone:608-848-5168
Practice Address - Fax:608-848-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2985152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI6024580001Medicare NSC
WI000047995Medicare PIN