National Provider Identifier Database

ROLLA EYE CLINIC
Rural Health


Contact Information

ROLLA EYE CLINIC
118 3RD ST. NE
ROLLA, ND58367-1170
Phone: 701-477-5656
Fax: 701-477-5675
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for ROLLA EYE CLINIC

NPI Number 1700064599
Legal business name
LBN
ROLLA EYE CLINIC
Authorized official JOSEPH THORMAN - (DOCTOR/OWNER)
Entity Organization
Organization subpart No
Enumeration date 02/05/2008
Last updated 03/04/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • ND License #: 540
  • ND Medicaid: 60650
  • ND Other: THO13533 BCBS
  • ND Other: 410048131 MEDICARE RAIL ROAD
  • ND Other: B48107221235 PREFERRED

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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