Organization
LADONNA SWAN INC
Active
Other names
Ocular Restoration Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA M. REINHARDT BCO (PRES OWNER)
(716) 649-4545
Entity
Organization
Contact information
Practice address
5895 SOUTHPARK AVE, HAMBURG, NY 14075-3738
(716) 649-4545
(716) 649-4545
Mailing address
5895 SOUTHPARK AVE, HAMBURG, NY 14075-3738
(716) 649-4545
(716) 649-4545
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
8217706
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011190001
UNIVERA HEALTHCARE
—
01
—
000589688001
BCBS OF WNY
—
01
—
0890048
INDEPENDENT HEALTH
—
01
—
OCUT01153006
VETERANS ADMINISTRATION
—
Enumeration date
12/26/2006
Last updated
08/06/2024
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