Optical West Inc

Organization Active NPI Clinic/Center · West Monroe, LA

NPI 1992854111 · NPPES record last updated Apr 2, 2012

Key facts

NPI
1992854111
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
Legal business name
OPTICAL WEST INC
Practice address
1110 North 7TH
West Monroe, LA 71291
Phone
(318) 387-4388
Fax
(318) 387-4343
NPI assigned
Jan 9, 2007
Organization subpart
No

Authorized official

Name
Mr. Benjamin Steven Dillingham
Title
President
Phone
(318) 387-4388

Practitioners 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930049865 LA DME Supplier - Optician
DME Supplier - Physician - Optometrist
9638298094 Practice locations: West Monroe, LA
O20240426002847 LA Part B Supplier - Clinic/Group Practice 9638298094 Receives reassigned benefits from 1 practitioner
Practice locations: West Monroe, LA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optician
Group: 193200000X MULTI-SPECIALTY GROUP
156FX1800X
Clinic/Center 261Q00000X Yes

Addresses

Primary practice location

1110 North 7TH
West Monroe, LA 71291

Mailing address

1110 North 7TH
West Monroe, LA 71291
Phone (318) 387-4388

Other identifiers

IdentifierTypeStateIssuer
1343544MedicaidLA

Other names

  • Dillingham Optical West Inc Doing business as

Other providers in West Monroe, LA

All providers in West Monroe, LA · Clinic/Center in Louisiana

Sources for this page

Verify at the official NPI Registry.