ROLLA EYE CLINIC; NPI #1700064599

Contact Information

ROLLA EYE CLINIC

118 3RD ST. NE
ROLLA, ND 58367-1170

Phone: 701-477-5656
Fax: 701-477-5675
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for ROLLA EYE CLINIC

NPI Number 1700064599

LBN Legal business name ROLLA EYE CLINIC

Authorized official JOSEPH THORMAN - (DOCTOR/OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/05/2008

Last updated 03/04/2009 - About 17 years ago

Identifiers

ND	License #	540
ND	Medicaid	60650
ND	Other	THO13533	BCBS
ND	Other	410048131	MEDICARE RAIL ROAD
ND	Other	B48107221235	PREFERRED

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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