Provider Demographics
NPI:1083862940
Name:PRITCHETT EYE CARE INCOPRORATED-CARSON
Entity Type:Organization
Organization Name:PRITCHETT EYE CARE INCOPRORATED-CARSON
Other - Org Name:PRITCHETT EYE CARE ASSOCIATES- CARSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:FERRIS
Authorized Official - Last Name:PRITCHETT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-359-2020
Mailing Address - Street 1:10459 DOUBLE R BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8905
Mailing Address - Country:US
Mailing Address - Phone:775-827-3030
Mailing Address - Fax:775-827-5479
Practice Address - Street 1:1987 N CARSON ST STE 5
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-1225
Practice Address - Country:US
Practice Address - Phone:775-883-2015
Practice Address - Fax:775-883-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV 445152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV37415Medicare PIN