Organization
OPTOMETRIC EYE CARE CENTERS, PA
Active
Other names
Eye Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY W KRAUPA OD (PRESIDENT)
(651) 777-3555
Entity
Organization
Contact information
Practice address
1965 11TH AVE E, SUITE 101, MAPLEWOOD, MN 55109-5167
(651) 777-3555
(651) 777-4459
Mailing address
1965 11TH AVE E, SUITE 101, MAPLEWOOD, MN 55109-5167
(651) 777-3555
(651) 777-4459
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1635
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08072KR
BCBS OF MN PRACTICE GRP
MN
01
—
2115755
MEDICA MN
MN
05
—
581713700
—
MN
Enumeration date
03/19/2007
Last updated
04/08/2008
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