Provider Demographics
NPI:1821107558
Name:VISION QUEST EYE CARE CENTER INC
Entity Type:Organization
Organization Name:VISION QUEST EYE CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARANIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:302-678-3545
Mailing Address - Street 1:820 WALKER RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2796
Mailing Address - Country:US
Mailing Address - Phone:302-678-3545
Mailing Address - Fax:302-734-3115
Practice Address - Street 1:820 WALKER RD
Practice Address - Street 2:SUITE C
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2796
Practice Address - Country:US
Practice Address - Phone:302-678-3545
Practice Address - Fax:302-734-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2001100892152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
X62256Medicare UPIN
DEG00564Medicare PIN