Provider Demographics
NPI:1336315530
Name:BEAR EYE CARE
Entity Type:Organization
Organization Name:BEAR EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:706-632-1995
Mailing Address - Street 1:91 OVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-6611
Mailing Address - Country:US
Mailing Address - Phone:706-632-1995
Mailing Address - Fax:
Practice Address - Street 1:91 OVERVIEW DR
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6611
Practice Address - Country:US
Practice Address - Phone:706-632-1995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT001406152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4796Medicare PIN