Provider Demographics
NPI:1699148692
Name:BD BAKER RENTALS LLC
Entity type:Organization
Organization Name:BD BAKER RENTALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-774-6288
Mailing Address - Street 1:P.O. BOX 746
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801
Mailing Address - Country:US
Mailing Address - Phone:906-774-6288
Mailing Address - Fax:906-774-6295
Practice Address - Street 1:2100 ARAGON STREET
Practice Address - Street 2:
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801
Practice Address - Country:US
Practice Address - Phone:906-774-6288
Practice Address - Fax:906-774-6295
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BD BAKER RENTALS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B26503001Medicare UPIN