Provider Demographics
NPI:1487627030
Name:EYECARE PROFESSIONALS - MOUNTAIN EYEWEAR
Entity Type:Organization
Organization Name:EYECARE PROFESSIONALS - MOUNTAIN EYEWEAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-222-0250
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:305 W PARK ST
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047
Mailing Address - Country:US
Mailing Address - Phone:406-222-0250
Mailing Address - Fax:406-222-8419
Practice Address - Street 1:305 W PARK ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047
Practice Address - Country:US
Practice Address - Phone:406-222-0250
Practice Address - Fax:406-222-8419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0483800001Medicare NSC