Miller Optometrists Inc
Organization Active NPI Optometrist · Delphos, OH
NPI 1649320441 · NPPES record last updated Oct 3, 2008
Key facts
- NPI
- 1649320441
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 3030H (OH)
- Legal business name
- MILLER OPTOMETRISTS INC
- Practice address
- 134 E 3Rd St
Delphos, OH 45833-1761 - Phone
- (419) 692-0010
- Fax
- (419) 695-4533
- NPI assigned
- Jan 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. John Eugene Grone, O.D.
- Title
- Ceo
- Phone
- (419) 692-0010
Practitioners 1
-
Lois A Spangler, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Miller Optometrists Inc |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100818000010 | OH | Part B Supplier - Clinic/Group Practice | 1355475906 |
Receives reassigned benefits from 1 practitioner Practice locations: Delphos, OH |
| O20100930052858 | OH | DME Supplier - Physician - Optometrist | 1355475906 | Practice locations: Delphos, OH |
National Provider Directory
Locations
134 E 3rd St
Delphos, OH 45833
Phone (419) 690-0010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 3030H | OH | Yes |
| Optometrist |
152W00000X | 4625OH | OH |
Addresses
Primary practice location
134 E 3Rd St
Delphos, OH 45833-1761
Mailing address
PO Box 159
Delphos, OH 45833-0159
Phone (419) 692-0010
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0157888 | Medicaid | OH | |
| 0265510 | Medicaid | OH |
Other names
- Delphos Vision Care
Other providers in Delphos, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2008. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.