Bennett Optometry LLC
Organization Active NPI Optometrist · Coldwater, MI
NPI 1265020143 · NPPES record last updated Jan 6, 2021
Key facts
- NPI
- 1265020143
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- BENNETT OPTOMETRY LLC
- Practice address
- 350 Marshall St
Coldwater, MI 49036-1175 - Phone
- (636) 200-4393
- Fax
- (636) 527-0766
- NPI assigned
- Jan 6, 2021
- Organization subpart
- No
Authorized official
- Name
- James Wachter
- Title
- Cmo
- Phone
- (636) 200-4393
Other NPIs on the same Medicare enrollment 19
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040419000779 | MI | Part B Supplier - Clinic/Group Practice | 5193719367 |
Receives reassigned benefits from 24 practitioners 19 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: East Lansing, MI; Three Rivers, MI; Tecumseh, MI; Saline, MI; Perry, MI; Okemos, MI; Novi, MI; Lansing, MI… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
350 Marshall St
Coldwater, MI 49036-1175
Mailing address
PO Box 208177
Dallas, TX 75320-8177
Phone (636) 200-4393
Other names
- Clarkson Eyecare
Other providers in Coldwater, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.