Provider Demographics
NPI:1891150256
Name:METRO EYECARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:METRO EYECARE ASSOCIATES LLC
Other - Org Name:ALTOONA EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TYKEIHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-270-0494
Mailing Address - Street 1:5501 NW 86TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1815
Mailing Address - Country:US
Mailing Address - Phone:515-270-0494
Mailing Address - Fax:515-270-0262
Practice Address - Street 1:1003 8TH ST SW
Practice Address - Street 2:SUITE C
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-2349
Practice Address - Country:US
Practice Address - Phone:515-967-4095
Practice Address - Fax:515-967-0262
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHNSTON EYECARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-29
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02298152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0289Medicare PIN