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General NPI Number Information
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NPI Number | 1902756133
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Entity Type | Organization
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Legal Business Name | APPLESEED EYECARE FW NORTHEAST, LLC
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 4201 LAHMEYER RD
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City | FORT WAYNE
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State | IN
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Zip | 46815-5676
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Country | US
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Telephone | 260-486-6106
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Fax | 260-486-5429
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Provider Business Mailing Address
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Address Line | 1752 E MARKET ST
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City | NAPPANEE
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State | IN
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Zip | 46550-9216
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Country | US
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Telephone | 574-773-4341
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Fax | 574-773-2324
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Authorized Official
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Title or Position | PRESIDENT
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Name | DARREN MINNICH
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Credential | OD
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Telephone | 574-773-4341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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