EAGLE RIVER VISION CLINIC INC (NPI# 1558301945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558301945 |
| Entity Type | Organization |
| Organization Name | EAGLE RIVER VISION CLINIC INC |
| Practice Address |
16331 Heritage Pl Suite 104 Eagle River AK 99577-7714 |
| Practice Telephone | 9076942511 |
| Practice Fax Number | 9076943900 |
| Mailing Telephone | 9076942511 |
| Mailing Fax Number | 9076943900 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2013-02-07 |
| Authorized Official Name | ROBERT JAY FLECKENSTEIN (PRESIDENT) |
| Authorized Official Telephone | 9076942511 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 310247 | AK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CMS EHR CERTIFICATAION ID | 30000001SWGYEAS | 01 |
| Street Address |
16331 HERITAGE PL SUITE 104 |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577-7714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770193278 | Caroline Irvin | Behavior Technician | 16331 Heritage Pl, Eagle River, AK 99577-7753 | 2020-08-09 |
| 1811511728 | Hailey Cherry | Behavior Technician | 16331 Heritage Pl, Eagle River, AK 99577-7753 | 2020-06-05 |
| 1407095318 | Joseph Fullerton Anderson | Chiropractor | 16331 Heritage Pl, Suite 101, Eagle River, AK 99577-7714 | 2009-02-17 |
| 1972652881 | Susan J Anderson, Dc Inc | Chiropractor | 16331 Heritage Pl, Suite 101, Eagle River, AK 99577-7714 | 2007-01-09 |
| 1417992553 | Levi Marc Porter | Optometrist | 16331 Heritage Pl, Ste 104, Eagle River, AK 99577-7753 | 2006-06-20 |
| 1730129131 | Robert Jay Fleckenstein | Optometrist | 16331 Heritage Pl, Suite 104, Eagle River, AK 99577-7714 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831758333 | Dianne E Lyons | Behavior Technician | 16331 Heritage Place, Suite 101, Eagle River, AK 99577 | 2019-06-07 |
| 1073007209 | Center for Natural Medicine, Inc. | Acupuncturist | 16844 Easy St, Eagle River, AK 99577 | 2018-06-20 |
| 1538652748 | Shelly Rana Budde | Nurse Practitioner | 19139 Upper Skyline Dr, Eagle River, AK 99577 | 2018-06-12 |
| 1700387529 | Aaron Wesley Jones | Behavior Technician | 16941 Notrh Eagle River Loop Road, Eagle River, Ak, AK 99577 | 2018-02-27 |
| 1033641881 | Sierra Bracken | Massage Therapist | 12812 Old Glenn Hwy, Ste C3, Eagle River, AK 99577 | 2017-03-31 |
| 1699213231 | Jolene Denee Rogers | Counselor | 13620 Old Glenn Hwy, Ste C, Eagle River, AK 99577 | 2017-02-02 |
| 1881040962 | Elizabeth Hanson | Behavioral Analyst | 16941 North Eagle River Loop Road, Suite 3, Eagle River, AK 99577 | 2016-05-09 |
| 1023496148 | Joel Richard Wallace | Dentist | 16727 Farm Avenue, Eagle River, AK 99577 | 2015-05-08 |
| 1184019663 | Nicole Christine Newman | Physician Assistant | 11432 Business Blvd., Suite 4, Eagle River, AK 99577 | 2015-04-01 |
| 1417365362 | Tammi Smith | Community Health Worker | 16510 Centerfield Dr B 107, Eagle River, AK 99577 | 2014-07-23 |
| Find all providers in zip 99577 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316353766 | Orthoalaska, LLC | Durable Medical Equipment & Medical Supplies | 13015 Old Glenn Hwy Ste 100, Eagle River, AK 99577-7572 | 2014-07-07 |
| 1104166479 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 12051 Old Glenn Hwy, Eagle River, AK 99577-7736 | 2013-02-25 |
| 1952537599 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 108 W Wall St, Eagle River, WI 54521-9811 | 2009-06-10 |
| 1477724805 | Select Physical Therapy Holdings Inc | Durable Medical Equipment & Medical Supplies | 12836 Old Glenn Hwy, Suite 101, Eagle River, AK 99577-7560 | 2008-03-13 |
| 1790861318 | Marshfield Clinic, Inc. | Durable Medical Equipment & Medical Supplies | 500 Commerce Loop, Eagle River, WI 54521-8835 | 2006-10-27 |
| 1588761977 | Health Care Pharmacies Inc. | Durable Medical Equipment & Medical Supplies | 123 East Wall St., Eagle River, WI 54521-0909 | 2006-09-20 |
| 1972520286 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 18600 Eagle River Rd, Eagle River, AK 99577-8688 | 2006-07-16 |
| 1174133920 | Carr-gottstein Foods Co | Durable Medical Equipment & Medical Supplies | 11431 Business Blvd, Eagle River, AK 99577-7754 | 2020-08-06 |
| 1629412804 | Family Health Center of Marshfield, Inc. | Durable Medical Equipment & Medical Supplies | 500 Commerce Loop, Eagle River, WI 54521-8038 | 2013-04-18 |
| 1013952548 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 13401 Old Glenn Hwy, Eagle River, AK 99577-7565 | 2006-06-18 |
| Find all providers in EAGLE RIVER | ||||
| City | EAGLE RIVER |
| Zip Code | 99577 |
Please comment or provide details below to improve the information on EAGLE RIVER VISION CLINIC INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.