Provider Demographics
NPI:1174662589
Name:ALL EYES LLC
Entity Type:Organization
Organization Name:ALL EYES LLC
Other - Org Name:DR REEDS ALL EYES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:REED
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:269-983-3200
Mailing Address - Street 1:2047 NILES ROAD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2505
Mailing Address - Country:US
Mailing Address - Phone:269-983-3200
Mailing Address - Fax:269-983-4902
Practice Address - Street 1:2047 NILES ROAD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2505
Practice Address - Country:US
Practice Address - Phone:269-983-3200
Practice Address - Fax:269-983-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0N37230Medicare ID - Type Unspecified
MI4338170001Medicare NSC