Provider Demographics
NPI:1407383334
Name:I CARE EYECARE
Entity Type:Organization
Organization Name:I CARE EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPO
Authorized Official - Phone:423-265-4306
Mailing Address - Street 1:2115 RIVER WATCH DR
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-3276
Mailing Address - Country:US
Mailing Address - Phone:423-303-6012
Mailing Address - Fax:423-265-4404
Practice Address - Street 1:WALMART VISION CENTER
Practice Address - Street 2:9334 DAYTON PIKE
Practice Address - City:SODDY-DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379
Practice Address - Country:US
Practice Address - Phone:423-332-8661
Practice Address - Fax:423-472-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD1896152W00000X
GAOPT001732152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty