Medicare Supplier WILLISTON BASIN EYECARE ASSOCIATES PC Details

Globally Unique Supplier Identifier: 20528207

medicare equipment supplier status:  active since 2011-08-01

Supplier: WILLISTON BASIN EYECARE ASSOCIATES PC

Reference Information. Full Replica of the CMS (NPPES) Record

Field Name Field Value
Supplier ID 20528207
Globally Unique Supplier Identifier
Company Name WILLISTON BASIN EYECARE ASSOCIATES PC
Supplier Company Name
Doing Business As (DBA) WILLISTON BASIN EYECARE ASSOCIATES
Alternative Company Name or Doing Business As (DBA)
Participation Begin Date 2011-08-01
Participation Begin Date
Address Line 1500 14TH ST W STE 100
Delivery Address Line
City WILLISTON
Business Address City
State ND
Business Address State
Zip 58801-4077
Business Address Zip
Phone Number 701-577-3937
Business Phone Number
Specialities List
  • Optometrist
Specialities List
Product Category Name(s)
  • Prosthetic Lenses: Conventional Contact Lenses
  • Prosthetic Lenses: Conventional Eyeglasses
Category, which supplier's products belong to (wheelchairs, scooters, surgical tools, etc.)
Latitude 48.15754
Business Practice Latitude
Longitude -103.64258
Business Practice Longitude
Is Contracted For CBA False
Is Contracted For CBA

Directions to the ❝WILLISTON BASIN EYECARE ASSOCIATES PC❞ location

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