Provider Demographics
NPI:1891846812
Name:ASSOCIATES IN EYECARE
Entity Type:Organization
Organization Name:ASSOCIATES IN EYECARE
Other - Org Name:DR SUSAN PERDUE
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICAN
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PERDUE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-624-2020
Mailing Address - Street 1:8470 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BIRCH RUN
Mailing Address - State:MI
Mailing Address - Zip Code:48415-9704
Mailing Address - Country:US
Mailing Address - Phone:989-624-2020
Mailing Address - Fax:989-624-6257
Practice Address - Street 1:8470 MAIN ST
Practice Address - Street 2:
Practice Address - City:BIRCH RUN
Practice Address - State:MI
Practice Address - Zip Code:48415-9704
Practice Address - Country:US
Practice Address - Phone:989-624-2020
Practice Address - Fax:989-624-6257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003182332B00000X
MI4901004706332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4743837Medicaid
MI900G311760OtherBCBSM
MI0982400OtherHEALTHPLUS
MI5416520003OtherDMERC
MIP15980003Medicare ID - Type UnspecifiedMEDICARE
MI0982400OtherHEALTHPLUS