Provider Demographics
NPI:1841401791
Name:VERRE EYE CLINIC, S.C.
Entity Type:Organization
Organization Name:VERRE EYE CLINIC, S.C.
Other - Org Name:THE OPTICAL SHOP VERRE YOUNG EYE CLINIC, S.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:VERRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-253-4000
Mailing Address - Street 1:N89W16785 APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2071
Mailing Address - Country:US
Mailing Address - Phone:262-253-1200
Mailing Address - Fax:
Practice Address - Street 1:N89W16785 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2071
Practice Address - Country:US
Practice Address - Phone:262-253-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI306 728 00Medicaid
WI317 946 00Medicaid
WI000467020Medicare ID - Type UnspecifiedDR. MARK A. MLSNA
WI000267020Medicare ID - Type UnspecifiedDR. JEFFREY S. YOUNG
WI5177280001Medicare NSC
WIF22255Medicare UPIN
WIP00080507Medicare ID - Type UnspecifiedJEFFREY S. YOUNG IND RR
WI000167020Medicare ID - Type UnspecifiedDR. WILLIAM P. VERRE
WI306 728 00Medicaid
WIV18837Medicare UPIN
WI000067020Medicare ID - Type UnspecifiedVERRE YOUNG EYE CLINIC SC
WI180045978Medicare ID - Type UnspecifiedWILLIAM P. VERRE RR
WIB57332Medicare UPIN
WI317 946 00Medicaid