Provider Demographics
NPI:1427170505
Name:OPTICAL ASSOCIATES INC
Entity type:Organization
Organization Name:OPTICAL ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MERLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAND
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:763-784-4081
Mailing Address - Street 1:15780 SKYLINE AVE NW
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-1629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1523 METRO DR
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-2378
Practice Address - Country:US
Practice Address - Phone:715-355-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI87247OtherSECURITY HEALTH PLAN
WI658297OtherPROVANTAGE
WI921513OtherVISION INS PLAN OF AMERCI
WI391735627OtherALLIED HEALTH
WI8627OtherAETNA
WIWI 2955OtherEYEMED
WIWI 2955OtherEYEMED
WI391735627OtherALLIED HEALTH
WI658297OtherPROVANTAGE