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Contact Information

ROSEAU/WARROAD EYE CLINIC, P.A.
301 LAKE STREET NE
WARROAD, MN56763
 Phone: 218-386-2081
 Fax: 218-386-1217
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ROSEAU/WARROAD EYE CLINIC, P.A.

NPI # 1861562340
LBN Legal business name ROSEAU/WARROAD EYE CLINIC, P.A.
Authorized official ROSS OLSON - (OWNER/OPTOMETRIST)
Entity Organization
Organization subpart 1 No
Enumeration date 11/09/2006
Last updated 08/05/2014 - About 12 years ago
Identifiers
MN License # #1693
MN License # 1618
MN License # 1693
MN License # 2946
MN Medicaid 275823700
MN Other 14000DI BLUE CROSS BLUE SHIELD
MN Other 14023ER BLUE CROSS BLUE SHIELD
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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