DESIGN 309 LLC, (NPI# 1457439416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457439416 |
| Entity Type | Organization |
| Organization Name | DESIGN 309 LLC, |
| Other Organization Name | GREAT LAKES VISION CENTER |
| Practice Address |
7609 Brockway Rd Brockway MI 48097-3459 |
| Practice Telephone | 8103879333 |
| Practice Fax Number | 8103879020 |
| Mailing Telephone | 8103879333 |
| Mailing Fax Number | 8103879020 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. CATHERINE ANNE BEDY (GENERAL MANAGER) |
| Authorized Official Telephone | 8103879333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Great Lakes Vision Center | Doing Business As Name - Organization |
| Street Address |
7609 BROCKWAY RD |
| City | BROCKWAY |
| State | MI |
| Zip Code | 48097-3459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659462943 | Mark D Revere | Optometrist | 7609 Brockway Rd, Brockway, MI 48097-3459 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215065271 | Tracy Lynn Krause | Physical Therapist | 7609 Brockway Road, Yale, MI 48097 | 2007-03-01 |
| 1336247485 | Alan Rutledge Bredin | Dentist | 333 Gordon Dr., Suite B, Yale, MI 48097 | 2006-09-20 |
| 1154425312 | Hubert Frederick Conlee | Chiropractor | 211 Brockway Rd, Yale, MI 48097 | 2006-09-11 |
| 1902882814 | Seema K Doshi | Internal Medicine | 333 Gordon Drive, Yale, MI 48097 | 2005-12-22 |
| 1093887598 | Winfred Darryl Williams | Family Medicine | 333 Gordon Drive, Yale, MI 48097 | 2006-11-14 |
| 1326146317 | Mary L. Vinckier, D.d.s., P.C. | Dentist | 333 Gordon Dr., Suite B, Yale, MI 48097 | 2006-09-21 |
| 1467559849 | Mary L. Vinckier | Dentist | 333 Gordon Drive, Suite B, Yale, MI 48097 | 2006-09-20 |
| 1285277616 | Giselle Gark | Behavior Technician | 8939 Brockway Rd, Brockway, MI 48097-2403 | 2019-10-17 |
| 1811346471 | Ashley Jones | Technician, Other | 12383 Jeddo Rd, Brockway, MI 48097-2410 | 2016-06-05 |
| 1275990921 | Keith Laurain | Specialist | 11339 Jeddo Rd, Brockway, MI 48097-2511 | 2016-01-26 |
| Find all providers in zip 48097 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
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|---|---|---|---|---|
| 1588201420 | William Wise | Technician/Technologist | 410 North St, Otisville, MI 48463-9705 | 2019-12-10 |
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| 1225595705 | National Vision Inc | Technician/Technologist | 1328 S Rochester Rd, Rochester Hills, MI 48307-3124 | 2019-02-21 |
| 1184191306 | National Vision Inc | Technician/Technologist | 50697 Waterside Dr, Chesterfield, MI 48051-4008 | 2018-10-25 |
| 1275045916 | W. Optical 4 LLC | Technician/Technologist | 1004 28th St Sw, Wyoming, MI 49509-2881 | 2017-11-03 |
| 1164932489 | Salim Rufo Auraha | Technician/Technologist | 3747 15 Mile Rd, Sterling Heights, MI 48310-5358 | 2017-10-02 |
| 1720527955 | Wal-mart Stores East, Lp | Technician/Technologist | 2755 W Holton-whitehall Rd, Whitehall, MI 49461 | 2017-02-21 |
| 1811434293 | Joseph Frye-dandridge | Technician/Technologist | 18669 Oakfield St, Detroit, MI 48235-3060 | 2017-01-24 |
| 1689110710 | W. Optical 2 LLC | Technician/Technologist | 3233 Alpine Ave Nw Ste A, Grand Rapids, MI 49544-1631 | 2017-01-12 |
| 1811377740 | Kat Stannis LLC | Technician/Technologist | 1794 N Old Us 23, Howell, MI 48843-7193 | 2015-06-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.