Provider Demographics
NPI:1518296748
Name:EYECARE FOR YOU, PC
Entity Type:Organization
Organization Name:EYECARE FOR YOU, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:BARCELOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-234-9728
Mailing Address - Street 1:1593 VT RT 107
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:VT
Mailing Address - Zip Code:05032
Mailing Address - Country:US
Mailing Address - Phone:802-234-9728
Mailing Address - Fax:802-234-9732
Practice Address - Street 1:1593 VT RT 107
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:VT
Practice Address - Zip Code:05032
Practice Address - Country:US
Practice Address - Phone:802-234-9728
Practice Address - Fax:802-234-9732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT300000196152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1017490Medicaid
VT0015006Medicare PIN
T25381Medicare UPIN
VT0688540001Medicare NSC