Provider Demographics
NPI:1689772014
Name:JOSEPH P MEURER JR MD
Entity Type:Organization
Organization Name:JOSEPH P MEURER JR MD
Other - Org Name:THE EYE GROUP DISPENSARY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:MEURER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-227-4175
Mailing Address - Street 1:200 SW MARKET ST
Mailing Address - Street 2:SUITE L-120
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5715
Mailing Address - Country:US
Mailing Address - Phone:503-227-4175
Mailing Address - Fax:503-226-2370
Practice Address - Street 1:200 SW MARKET ST
Practice Address - Street 2:SUITE L-120
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5715
Practice Address - Country:US
Practice Address - Phone:503-227-4175
Practice Address - Fax:503-226-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0984450001Medicare NSC