Provider Demographics
NPI:1508964867
Name:EYECARE PROFESSIONALS PC
Entity Type:Organization
Organization Name:EYECARE PROFESSIONALS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:HELMERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:701-663-2020
Mailing Address - Street 1:113 3RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-3129
Mailing Address - Country:US
Mailing Address - Phone:701-663-2020
Mailing Address - Fax:701-667-2057
Practice Address - Street 1:113 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-3129
Practice Address - Country:US
Practice Address - Phone:701-663-2020
Practice Address - Fax:701-667-2057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND60524Medicaid
NDN70893Medicare PIN
ND60524Medicaid