Provider Demographics
NPI:1255815205
Name:LINN COUNTY VISION CENTER, LLC
Entity type:Organization
Organization Name:LINN COUNTY VISION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND SOLE MEMBER OF LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DROBECK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:760-261-8339
Mailing Address - Street 1:1825 CLOUDBURST AVE NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-2818
Mailing Address - Country:US
Mailing Address - Phone:760-261-8339
Mailing Address - Fax:
Practice Address - Street 1:2169 14TH AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-8510
Practice Address - Country:US
Practice Address - Phone:541-928-6118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-16
Last Update Date:2018-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty