Provider Demographics
NPI:1699847293
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 1:3051 25TH ST S
Practice Address - Street 2:SUITE K2
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6102
Practice Address - Country:US
Practice Address - Phone:701-234-0766
Practice Address - Fax:701-234-0769
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
ND02730002OtherBLUE CROSS BLUE SHIELD ND
ND23180OtherPREFERRED ONE
ND60586Medicaid
ND2100336OtherMEDICA
ND98387OtherHEALTH PARTNERS
NDN711326Medicare PIN
ND98387OtherHEALTH PARTNERS