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NPI 1356498075

NPI 1356498075 : OCULARRA HOLDING. INC : BLAINE, MN

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General NPI Number Information
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    NPI Number           |    1356498075
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    Entity Type          |    Organization 
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    Legal Business Name  |    OCULARRA HOLDING. INC 
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Dates
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    Enumeration Date     |    01/04/2007
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    570 NORTHTOWN DR NE 
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    City                 |    BLAINE
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    State                |    MN
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    Zip                  |    55434-1043
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    Country              |    US
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    Telephone            |    763-784-4081
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    Fax                  |    763-784-0694
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Provider Business Mailing Address
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    Address Line         |    15780 SKYLINE AVE NW 
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    City                 |    PRIOR LAKE
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    State                |    MN
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    Zip                  |    55372-1629
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. MERLIN  STRAND JR.
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    Credential           |    
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    Telephone            |    763-784-4081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    156FX1800X
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    Taxonomy Name        |    Optician
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    
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    License Number State |    
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