Healthcare Provider Details

I. General information

NPI: 1801819941
Provider Name (Legal Business Name): RIVERTOWN EYE CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N FRONTAGE RD
HASTINGS MN
55033-2662
US

IV. Provider business mailing address

1011 N FRONTAGE RD
HASTINGS MN
55033-2662
US

V. Phone/Fax

Practice location:
  • Phone: 651-437-5469
  • Fax: 651-437-2910
Mailing address:
  • Phone: 651-437-5469
  • Fax: 651-437-2910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: ERIC ROBERT SLAPNICHER
Title or Position: PRESIDENT/OWNER/CEO
Credential: OD
Phone: 651-437-5469