# RETINA CARE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Retina Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568422053
- **Authorized official:** ADAM C AUFDERHEIDE MD (MEMBER)
- **Authorized official phone:** (541) 842-2020

## Contact information

- **Practice address:** 748 STATE ST, MEDFORD, OR 97504-8473
- **Practice address phone:** (541) 842-2020
- **Practice address fax:** (541) 842-2022
- **Mailing address:** 748 STATE ST, MEDFORD, OR 97504-8473
- **Mailing address phone:** (541) 842-2020
- **Mailing address fax:** (541) 842-2022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WV0400X | Vision Therapy Optometrist | — | NULL | — |
| 152WV0400X | Vision Therapy Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/27/2006
- **Last updated:** 08/14/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 286236 | — | OR |
| 01 | — | CK6077 | MEDICARE RAILROAD | OR |