Provider Demographics
NPI:1114369766
Name:P AND B EYE CARE, LLC
Entity Type:Organization
Organization Name:P AND B EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:POLLASTRINI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:319-483-5185
Mailing Address - Street 1:1300 10TH AVENUE SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-3771
Mailing Address - Country:US
Mailing Address - Phone:319-483-5185
Mailing Address - Fax:319-483-5184
Practice Address - Street 1:1300 10TH AVENUE SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-3771
Practice Address - Country:US
Practice Address - Phone:319-483-5185
Practice Address - Fax:319-483-5184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA6810510001Medicare NSC