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NPI Code Detail

MEDICARE: BOGAR VISION CARE LLC

MEDICARE: BOGAR VISION CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

General Provider Information

NPI Number : 1417705625
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOGAR VISION CARE LLC
Provider Business Mailing Address
First Line : 337 BERRY MOUNTAIN RD
Second Line :
City : MILLERSBURG
State : PA
Zip : 17061-1809
Country : US
Telephone Number : 570-441-6736
Fax Number :
Provider Business Practice Location Address
First Line : 301 EAST ST
Second Line :
City : BLOOMSBURG
State : PA
Zip : 17815-1846
Country : US
Telephone Number : 570-387-8800
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : MR. LARS D BOGAR
Credential : OD
Telephone Number : 570-441-6736
Provider Enumeration Date : 05/11/2024
Last Update Date : 06/12/2024

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Directions to “BOGAR VISION CARE LLC ” Practice Location

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