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NPI Code Detail

MEDICARE: MERLENBACH OPTOMETRY, P.C.

MEDICARE: MERLENBACH OPTOMETRY, P.C.
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
1152WC0802XCorneal and Contact Management Optometrist2000169300MO

General Provider Information

NPI Number : 1689880767
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERLENBACH OPTOMETRY, P.C.
Provider Business Mailing Address
First Line : 2757 WHITECREEK LN
Second Line :
City : IMPERIAL
State : MO
Zip : 63052-4358
Country : US
Telephone Number : 314-781-1734
Fax Number : 314-781-0056
Provider Business Practice Location Address
First Line : 1900 MAPLEWOOD COMMONS DR
Second Line :
City : MAPLEWOOD
State : MO
Zip : 63143-1005
Country : US
Telephone Number : 314-781-1734
Fax Number : 314-781-0056
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHAEL MATTHEW MERLENBACH SR.
Credential : O.D.
Telephone Number : 314-781-1734
Provider Enumeration Date : 05/15/2007
Last Update Date : 08/22/2020

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