Provider Demographics
NPI:1578830410
Name:PREFERRED EYECARE, INC.
Entity Type:Organization
Organization Name:PREFERRED EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:218-829-2607
Mailing Address - Street 1:PO BOX 942
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-0942
Mailing Address - Country:US
Mailing Address - Phone:218-829-2607
Mailing Address - Fax:
Practice Address - Street 1:7295 GLORY RD
Practice Address - Street 2:WALMART VISION CENTER 1654
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-7308
Practice Address - Country:US
Practice Address - Phone:218-829-3848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3152152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty