Provider Demographics
NPI:1659811511
Name:EYECARE DOCTOR LLC
Entity Type:Organization
Organization Name:EYECARE DOCTOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HUDISH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-917-6363
Mailing Address - Street 1:1465 LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-9768
Mailing Address - Country:US
Mailing Address - Phone:717-879-6900
Mailing Address - Fax:717-879-6901
Practice Address - Street 1:1172 GRAYSTONE RD
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-8822
Practice Address - Country:US
Practice Address - Phone:717-917-6363
Practice Address - Fax:717-459-3482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-26
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET008805152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty