Provider Demographics
NPI:1083702104
Name:PRIMARY EYE CARE ASSOCIATES, OD, PA
Entity Type:Organization
Organization Name:PRIMARY EYE CARE ASSOCIATES, OD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:SATTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:828-255-8961
Mailing Address - Street 1:417 BILTMORE AVE
Mailing Address - Street 2:4 DOCTORS PARK SUITE J1
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4543
Mailing Address - Country:US
Mailing Address - Phone:828-255-8961
Mailing Address - Fax:828-255-8962
Practice Address - Street 1:417 BILTMORE AVE
Practice Address - Street 2:4 DOCTORS PARK SUITE J1
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4543
Practice Address - Country:US
Practice Address - Phone:828-255-8961
Practice Address - Fax:828-255-8962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1156152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909809Medicaid
0688430002Medicare NSC
NC246449BMedicare PIN
T64980Medicare UPIN