Provider Demographics
NPI:1497412530
Name:PRIME EYECARE PC
Entity Type:Organization
Organization Name:PRIME EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMMERSCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:701-494-0020
Mailing Address - Street 1:4701 BOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-7468
Mailing Address - Country:US
Mailing Address - Phone:701-494-0020
Mailing Address - Fax:
Practice Address - Street 1:1300 E LASALLE DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-5716
Practice Address - Country:US
Practice Address - Phone:701-557-1574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty