Provider Demographics
NPI:1639329386
Name:ANTHEM EYE CARE, P. C.
Entity Type:Organization
Organization Name:ANTHEM EYE CARE, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:623-879-3937
Mailing Address - Street 1:3655 W ANTHEM WAY
Mailing Address - Street 2:SUITE B 149
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086
Mailing Address - Country:US
Mailing Address - Phone:623-879-3937
Mailing Address - Fax:
Practice Address - Street 1:3655 W ANTHEM WAY
Practice Address - Street 2:SUITE B 149
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086
Practice Address - Country:US
Practice Address - Phone:623-879-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0902850OtherBCBS
211518OtherEYEMED
25628OtherAVESIS
AE26751OtherSPECTERA
64432Medicare UPIN
AZZ127454Medicare PIN