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Contact Information

TAWAS BAY OPTICAL INC.
1691 N US 23
SUITE 2
EAST TAWAS, MI48730
 Phone: 989-362-9546
 Fax: 989-362-9567
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for TAWAS BAY OPTICAL INC.

NPI Number 1104942135
LBN Legal business name TAWAS BAY OPTICAL INC.
Authorized official DANIEL SMITH - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/21/2007
Last updated 09/15/2011 - About 15 years ago
Identifiers
MI License # 4901003153
MI Other 0M89210001 BCBSM MEDICARE ADVANTAGE
MI Other 900C510060 BLUE CROSS BLUE SHIELD
MI Other 1291550002 DMERC
MI Other 410046393 RAILROAD MEDICARE
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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