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Contact Information

CADILLAC EYE CLINIC PC
502 COBB ST
CADILLAC, MI49601-2577
 Phone: 231-775-1248
 Fax: 231-775-1156
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for CADILLAC EYE CLINIC PC

NPI # 1831174879
LBN Legal business name CADILLAC EYE CLINIC PC
Authorized official RICHARD BRENZ - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/13/2005
Last updated 04/22/2010 - About 16 years ago
Identifiers
MI Medicaid 3255157
MI Other 180H34653 BCBSM
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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