Pine River Eye Center, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1895 Issued in MN

Legal business name

PINE RIVER EYE CENTER, INC.

Practice address

424 Barclay Ave.
Pine River, MN 56474-0457

Phone

(218) 587-2020

Fax

(218) 587-3229

NPI assigned

Aug 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael S. Marvin, O.D.

Title

Ceo

Phone

(218) 587-2020

Specialties & licenses 1

Addresses

Other names 1

• Associates In Eyecare Doing business as

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pine River Eye Center, Inc.

  • Eyewear Supplier
  • Nisswa, MN
  • NPI 1073812418
  NPPES parent name
• Pine River Eye Center, Inc.

  • Eyewear Supplier
  • Baxter, MN
  • NPI 1508165572
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1124035191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "PINE RIVER",
            "state": "MN",
            "postal_code": "564740457",
            "telephone_number": "218-587-2020",
            "fax_number": "218-587-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 BARCLAY AVE.",
            "city": "PINE RIVER",
            "state": "MN",
            "postal_code": "564740457",
            "telephone_number": "218-587-2020",
            "fax_number": "218-587-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE RIVER EYE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "MARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-587-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Associates In Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Northwoods Dna, Inc.
• Taylor Anne Ott, PHARMD
• Pine River Dental Arts, P.C.
• Pine River Dental Center LLC
• Pine River Dental Center LLC
• Annette M Pohl, LPT
• Jaime Lyn Preble, DDS
• Ronald Lee Prouty, DC
• Amalia Richards, CLC
• Anton Sauer, DDS

• Optometrist in Pine River, MN
• Providers in Pine River, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.