Provider Demographics
NPI:1447618525
Name:PARMELEE EYE CARE LLC
Entity Type:Organization
Organization Name:PARMELEE EYE CARE LLC
Other - Org Name:GLYNN EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARMELEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:912-222-3453
Mailing Address - Street 1:1909 GLOUCESTER ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-6906
Mailing Address - Country:US
Mailing Address - Phone:912-275-7741
Mailing Address - Fax:
Practice Address - Street 1:1909 GLOUCESTER ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520
Practice Address - Country:US
Practice Address - Phone:912-222-3453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002879305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I414978Medicare PIN