Medical Eye Associates, S.C.
Eyewear Supplier (Equipment, not the service) in Mukwonago, WI. Organization (NPI-2).
NPI number1124450168
StatusActive
Last updated in NPPESOct 9, 2023
Details
- NPI
- 1124450168
- Entity type
- Organization (NPI-2)
- Legal business name
- Medical Eye Associates, S.C.
- Organization subpart
- Yes
- Enumeration date
- Aug 1, 2013
- Certification date
- Oct 9, 2023
- Last updated
- Oct 9, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
Other names
- Main Optical (Other Name)
Practice location
400 Bay View RdSuite D
Mukwonago, WI 53149-1770
Phone 262-363-1515
Mailing address
1111 Delafield StSuite 312
Waukesha, WI 53188-3417
Phone 262-547-3352
Authorized official
Gregory R. Lochen
President
2625473352
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