Provider Demographics
NPI:1144613852
Name:EYECARE FOR YOU, PC
Entity Type:Organization
Organization Name:EYECARE FOR YOU, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARCELOW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:802-234-9728
Mailing Address - Street 1:1593 VT RTE 107
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:VT
Mailing Address - Zip Code:05032-4456
Mailing Address - Country:US
Mailing Address - Phone:802-234-9728
Mailing Address - Fax:802-234-9732
Practice Address - Street 1:1593 VT RTE 107
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:VT
Practice Address - Zip Code:05032-4456
Practice Address - Country:US
Practice Address - Phone:802-234-9728
Practice Address - Fax:802-234-9732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT030.0000196332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0006624Medicaid
VT1022362Medicaid
VT1016712Medicaid
VT001510401Medicare PIN
VT1016712Medicaid
VTVT662401Medicare PIN