Provider Demographics
NPI:1033239215
Name:CAPITOL EYE CARE, INC.
Entity Type:Organization
Organization Name:CAPITOL EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HELMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-659-5454
Mailing Address - Street 1:1705 CHRISTY DR
Mailing Address - Street 2:STE. 101
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-5195
Mailing Address - Country:US
Mailing Address - Phone:573-635-0115
Mailing Address - Fax:573-635-0116
Practice Address - Street 1:1705 CHRISTY DR
Practice Address - Street 2:STE. 101
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-5195
Practice Address - Country:US
Practice Address - Phone:573-635-0115
Practice Address - Fax:573-635-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000011745Medicare PIN
MO000005264Medicare PIN