Provider Demographics
NPI:1891439600
Name:PREMIER EYE MARLTON, LLC
Entity Type:Organization
Organization Name:PREMIER EYE MARLTON, LLC
Other - Org Name:PREMIER EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:JOHN MICHAEL
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-858-3937
Mailing Address - Street 1:571 HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1445
Mailing Address - Country:US
Mailing Address - Phone:856-988-1118
Mailing Address - Fax:856-988-0947
Practice Address - Street 1:701 ROUTE 73 N STE 3
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3466
Practice Address - Country:US
Practice Address - Phone:856-858-3937
Practice Address - Fax:856-425-2571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty