Provider Demographics
NPI:1023121746
Name:PIERCE EYE CARE LLC
Entity type:Organization
Organization Name:PIERCE EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-732-5233
Mailing Address - Street 1:950 EDELWEISS PKWY
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-0000
Mailing Address - Country:US
Mailing Address - Phone:989-732-5233
Mailing Address - Fax:989-732-5344
Practice Address - Street 1:950 EDELWEISS PARKWAY
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-0000
Practice Address - Country:US
Practice Address - Phone:989-732-5233
Practice Address - Fax:989-732-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003832152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU63382Medicare UPIN