Provider Demographics
NPI:1952591810
Name:VALE PARK EYE CLINIC, INC.
Entity Type:Organization
Organization Name:VALE PARK EYE CLINIC, INC.
Other - Org Name:LOUIS C. BEJEC, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:CASTILLO
Authorized Official - Last Name:BEJEC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-464-2020
Mailing Address - Street 1:401 WALL ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2521
Mailing Address - Country:US
Mailing Address - Phone:219-464-2020
Mailing Address - Fax:219-531-0730
Practice Address - Street 1:401 WALL ST
Practice Address - Street 2:SUITE C
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2521
Practice Address - Country:US
Practice Address - Phone:219-464-2020
Practice Address - Fax:219-531-0730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01028497A261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0270710001Medicare NSC
INB29261Medicare UPIN
IN653430Medicare PIN