Provider Demographics
NPI:1083729479
Name:EYE WORKS, INC.
Entity Type:Organization
Organization Name:EYE WORKS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEICHLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:605-718-7550
Mailing Address - Street 1:685 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2518
Mailing Address - Country:US
Mailing Address - Phone:605-718-7550
Mailing Address - Fax:
Practice Address - Street 1:685 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2518
Practice Address - Country:US
Practice Address - Phone:605-718-7550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSD484152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9202623Medicaid
SDD-31677Medicare UPIN
SD4974060001Medicare NSC