Provider Demographics
NPI:1619742178
Name:COMPREHENSIVE EYE CARE ASSOCIATES PC
Entity Type:Organization
Organization Name:COMPREHENSIVE EYE CARE ASSOCIATES PC
Other - Org Name:COMPREHENSIVE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SLATE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:231-742-2541
Mailing Address - Street 1:2700 5 MILE RD NE STE 102
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-6516
Mailing Address - Country:US
Mailing Address - Phone:616-361-6612
Mailing Address - Fax:616-361-6690
Practice Address - Street 1:2700 5 MILE RD NE STE 102
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-6516
Practice Address - Country:US
Practice Address - Phone:616-361-6612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty