Provider Demographics
NPI:1821168253
Name:REDMAN & GELINAS S C
Entity Type:Organization
Organization Name:REDMAN & GELINAS S C
Other - Org Name:EYE WEAR ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRBY
Authorized Official - Middle Name:D
Authorized Official - Last Name:REDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:715-356-2262
Mailing Address - Street 1:PO BOX 1520
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568-1520
Mailing Address - Country:US
Mailing Address - Phone:715-356-2262
Mailing Address - Fax:715-356-2257
Practice Address - Street 1:1020 3RD AVE
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:WI
Practice Address - Zip Code:54568-9492
Practice Address - Country:US
Practice Address - Phone:715-356-2262
Practice Address - Fax:715-356-2257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
1314520001Medicare NSC