PBW OPTOMETRY PC; NPI #1871048405

Contact Information

PBW OPTOMETRY PC

1923 MCCULLOCH BLVD #102
LAKE HAVASU CITY, AZ 86403-6722

Phone: 928-854-3555
Fax: 928-854-4544
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Eyewear Supplier	332H00000X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for PBW OPTOMETRY PC

NPI Number 1871048405

LBN Legal business name PBW OPTOMETRY PC

Authorized official DOONE BURGENER - (BUSINESS MANAGER)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/24/2016

Last updated 08/09/2017 - About 9 years ago

Identifiers

AZ	License #	1060
	Other	7547290001	MEDICARE NSC

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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PBW OPTOMETRY PC

Contact Information

Specialty

Eyewear Supplier

NPI Profile & details for PBW OPTOMETRY PC

Reviews for PBW OPTOMETRY PC