Provider Demographics
NPI:1205856119
Name:COMPREHENSIVE EYE CARE, LTD.
Entity Type:Organization
Organization Name:COMPREHENSIVE EYE CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:KORENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-390-3999
Mailing Address - Street 1:901 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-3010
Mailing Address - Country:US
Mailing Address - Phone:636-390-3999
Mailing Address - Fax:636-390-3959
Practice Address - Street 1:901 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-3010
Practice Address - Country:US
Practice Address - Phone:636-390-3999
Practice Address - Fax:636-390-3959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1P88261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO500561303Medicaid
MO0731740001Medicare NSC
MO990001667Medicare PIN