Provider Demographics
NPI:1417705625
Name:BOGAR VISION CARE LLC
Entity type:Organization
Organization Name:BOGAR VISION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARS
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOGAR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:570-441-6736
Mailing Address - Street 1:337 BERRY MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17061-1809
Mailing Address - Country:US
Mailing Address - Phone:570-441-6736
Mailing Address - Fax:
Practice Address - Street 1:301 EAST ST
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-1846
Practice Address - Country:US
Practice Address - Phone:570-387-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-11
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty