Warren Eye Care, P.C.
Organization Active NPI Optometrist · Warren, MN
NPI 1891995460 · NPPES record last updated Oct 31, 2011
Key facts
- NPI
- 1891995460
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 2847 (MN)
- Legal business name
- WARREN EYE CARE, P.C.
- Practice address
- 205 W Johnson Ave
Suite #1
Warren, MN 56762-1118 - Phone
- (218) 745-5151
- Fax
- (218) 745-6000
- NPI assigned
- Jul 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Stacey Jean Bienek, O.D.
- Title
- Owner/Optometrist
- Phone
- (218) 745-5151
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050517000043 | MN | Part B Supplier - Clinic/Group Practice | 3375584790 |
Receives reassigned benefits from 1 practitioner Practice locations: Warren, MN |
National Provider Directory
Locations
205 W Johnson Ave
Ste 1
Warren, MN 56762
Phone (218) 745-5151
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 2847 | MN | Yes |
Addresses
Primary practice location
205 W Johnson Ave
Suite #1
Warren, MN 56762-1118
Mailing address
205 W Johnson Ave
Suite #1
Warren, MN 56762-1118
Phone (218) 745-5151
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 779407000 | Medicaid | MN |
Other providers in Warren, MN
- The Evangelical Lutheran Good Samaritan Society
- Warren Community Hospital, Inc.
- Warren Community Hospital, Inc.
- Warren Community Hospital, Inc.
- Warren Economic Development Authority
- Warren Pharmacy Inc
- Warren Pharmacy Inc
- Warren-Alvarado-Oslo Public School District No 2176
- Anita Whalen
- Michelle Marie Woinarowicz
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2011. 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.