GROSSNICKLE EYE CENTER INC. NPI 1134259179

NPI Information

NPI: 1134259179
Provider Name: GROSSNICKLE EYE CENTER, INC.

Doing Business As: GROSSNICKLE EYE SURGERY CENTER

Classification: Clinic/Center - 261QS0132X
Entity Type: Organization

Specialization: Ophthalmologic Surgery

Address:
2251 DUBOIS DR
WARSAW, IN
ZIP 46580
Phone: (574) 269-2777
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GROSSNICKLE EYE CENTER, INC. is an ophthalmologic surgery clinic center in Warsaw, IN. GROSSNICKLE EYE CENTER, INC. NPI is 1134259179. The provider is registered as an organization entity type.
The provider Is Doing Business As Grossnickle Eye Surgery Center.

The provider's business location address is:

2251 DUBOIS DR
WARSAW, IN
ZIP 46580-212
Phone: (574) 269-2777
Fax: (574) 371-4697

The provider's authorized official is Bruce P. Grossnickle .
The authorized official title is Medical Director and has the following contact phone number (574) 269-2777.

The enumeration date for this NPI number is 3/7/2007 and was last updated on 10/20/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	50001530A	INDIANA	No
2	261QS0132X	Clinic/Center	Ophthalmologic Surgery	50001530A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100274260A	MEDICAID	INDIANA
2	ZR0190	MEDICARE PIN	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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