Provider Demographics
NPI:1225343965
Name:PRITCHETT EYE CARE PC
Entity Type:Organization
Organization Name:PRITCHETT EYE CARE PC
Other - Org Name:PRITCHETT EYE CARE ASSOCIATES (MOANA)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PECA
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BENITZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-848-3859
Mailing Address - Street 1:5961 LOS ALTOS PKWY STE 101
Mailing Address - Street 2:STE 101
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-2501
Mailing Address - Country:US
Mailing Address - Phone:775-359-2020
Mailing Address - Fax:775-359-2676
Practice Address - Street 1:285 W MOANA LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4905
Practice Address - Country:US
Practice Address - Phone:775-826-2477
Practice Address - Fax:775-856-1524
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRITCHETT EYE CARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-18
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1225343965Medicaid
NVV37415Medicare PIN
NV1225343965Medicaid