Organization
OAP I LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI K VIRGIL (BILLING DEPT MANAGER)
(574) 291-9200
Entity
Organization
Contact information
Practice address
332 N MICHIGAN ST, SOUTH BEND, IN 46601-1226
(574) 232-5955
(574) 232-5862
Mailing address
332 N MICHIGAN ST, SOUTH BEND, IN 46601-1226
(574) 232-5955
(574) 232-5862
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200829710
—
IN
Enumeration date
08/24/2007
Last updated
04/30/2008
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