Provider Demographics
NPI:1922276310
Name:AURORA FAMILY VISION CARE, LLC
Entity Type:Organization
Organization Name:AURORA FAMILY VISION CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-678-1177
Mailing Address - Street 1:320 S MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:MO
Mailing Address - Zip Code:65605-1569
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:320 S MADISON AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:MO
Practice Address - Zip Code:65605-1569
Practice Address - Country:US
Practice Address - Phone:417-678-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT03480332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO314723206Medicaid
350049029OtherPALMETTO MEDICARE
350049029OtherPALMETTO MEDICARE
U76143Medicare UPIN
MOMA2696Medicare PIN