Organization
INDIANA VISION CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD MILOVICH OD (OWNER)
(574) 266-5470
Entity
Organization
Contact information
Practice address
2730A CASSOPOLIS ST, ELKHART, IN 46514-5102
(574) 266-5470
(574) 264-3081
Mailing address
2730A CASSOPOLIS ST, ELKHART, IN 46514-5102
(574) 266-5470
(574) 264-3081
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001593A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000273028
BCBS ELKHART GROUP
IN
05
—
200380990B
—
IN
01
—
2550910002
DURABLE MEDICAL EQUIP
IN
Enumeration date
08/09/2006
Last updated
10/21/2010
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