Provider Demographics
NPI:1740429711
Name:PREMIER EYECARE P.C.
Entity Type:Organization
Organization Name:PREMIER EYECARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:605-399-3937
Mailing Address - Street 1:318 MOUNT RUSHMORE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2769
Mailing Address - Country:US
Mailing Address - Phone:605-399-3937
Mailing Address - Fax:
Practice Address - Street 1:318 MOUNT RUSHMORE RD
Practice Address - Street 2:SUITE A
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2769
Practice Address - Country:US
Practice Address - Phone:605-399-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD608152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty