Provider Demographics
NPI:1689747230
Name:MIDWEST VISION CENTERS INC
Entity Type:Organization
Organization Name:MIDWEST VISION CENTERS INC
Other - Org Name:MIDWEST VISION CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARIN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-466-5777
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56302-0456
Mailing Address - Country:US
Mailing Address - Phone:888-466-5777
Mailing Address - Fax:320-258-3136
Practice Address - Street 1:318 JEFFERSON ST S
Practice Address - Street 2:
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482-1556
Practice Address - Country:US
Practice Address - Phone:218-631-3300
Practice Address - Fax:218-632-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN564198500Medicaid
MN106220OtherHEALTH PARTNERS
MN180612OtherUCARE
MN23180OtherPREFERRED ONE
MNDB6547OtherRAILROAD MEDICARE
MN2100586OtherMEDICA
MN430L0MIOtherBLUE CROSS BLUE SHIELD
MNC03837Medicare PIN