Provider Demographics
NPI:1134430309
Name:RICHARD ERIC STRAIN, O.D., P.L.C.
Entity type:Organization
Organization Name:RICHARD ERIC STRAIN, O.D., P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:STRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-684-8840
Mailing Address - Street 1:600 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-3210
Mailing Address - Country:US
Mailing Address - Phone:989-684-8840
Mailing Address - Fax:
Practice Address - Street 1:600 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3210
Practice Address - Country:US
Practice Address - Phone:989-684-8840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002874152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5097861Medicaid
MI3045Medicare PIN
900Z965190Medicare PIN
T33917Medicare UPIN
MI5097861Medicaid