Medical Eye Center Optical Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

MEDICAL EYE CENTER OPTICAL INC

Practice address

1333 E Barnett Rd
Medford, OR 97504-8219

Phone

(541) 779-4711

Fax

(541) 618-1485

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Keith Casebolt

Title

Ceo

Phone

(541) 779-4711

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1366510034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048219",
            "telephone_number": "541-779-4711",
            "fax_number": "541-618-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048219",
            "telephone_number": "541-779-4711",
            "fax_number": "541-618-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EYE CENTER OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "CASEBOLT",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-779-4711"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040654",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mindie A Medina, BA
• Bruce Medlin
• Nancy Medlin, SLP
• Alma Yesenia Medrano Jacuinde
• Susana Medrano, RN

• Eyewear Supplier in Medford, OR
• Providers in Medford, OR by specialty
• Eyewear Supplier in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.