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
1	152W00000X	Optometrist

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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