Provider Demographics
NPI:1952320129
Name:ERIC R. MILLER, OD, PC
Entity Type:Organization
Organization Name:ERIC R. MILLER, OD, PC
Other - Org Name:MILLER EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-869-4200
Mailing Address - Street 1:57 JENNERS VILLAGE CENTER
Mailing Address - Street 2:
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9189
Mailing Address - Country:US
Mailing Address - Phone:610-869-4200
Mailing Address - Fax:
Practice Address - Street 1:57 JENNERS VILLAGE CENTER
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9189
Practice Address - Country:US
Practice Address - Phone:610-869-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000294152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019738150001Medicaid
PA4753500001Medicare NSC
PA0019738150001Medicaid