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Contact Information

J BASS LTD
112 S 42ND STREET
MOUNT VERNON, IL62864
 Phone: 618-244-0508
 Fax: 618-244-0646
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for J BASS LTD

NPI Number 1497814305
LBN Legal business name J BASS LTD
Authorized official TINA TEPOVICH - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/06/2006
Last updated 09/13/2011 - About 15 years ago
Identifiers
IL Other 1922009950 BCBS
IL Other DE6294 RR 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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