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Louisville Optometric Centers, III PSC

Organization Active NPI Eyewear Supplier · Salem, IN

NPI 1285704866 · NPPES record last updated Feb 19, 2014

Key facts

NPI
1285704866
Entity type
Organization (NPI type 2)
Primary specialty
Eyewear Supplier 332H00000X
License
5419240006 (IN)
Legal business name
LOUISVILLE OPTOMETRIC CENTERS, III PSC
Practice address
600 S Main St
Salem, IN 47167-1040
Phone
(812) 883-2700
Fax
(812) 883-2752
NPI assigned
Nov 9, 2006
Organization subpart
No

Authorized official

Name
Dr. Rod L. Rallo, O.D. NPI 1831181973
Title
Owner and Optometrist
Phone
(502) 459-2020

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 38

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Louisville Optometric Centers III,
600 S Main St, Salem, IN 47167-1040 · (812) 883-2700		 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignment
Participating since Jan 1, 2005

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930044523 IN DME Supplier - Physician - Optometrist 8729041926 Practice locations: Salem, IN

National Provider Directory

Tax ID family
Louisville Optometric I (33 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 5419240006 IN Yes

Addresses

Primary practice location

600 S Main St
Salem, IN 47167-1040

Mailing address

600 S Main St
Salem, IN 47167-1040
Phone (812) 883-2700

Other names

  • VisionFirst Doing business as

Other providers in Salem, IN

All providers in Salem, IN · Eyewear Supplier in Indiana

Sources for this page

Verify at the official NPI Registry.