Provider Demographics
NPI:1154518116
Name:PRIMARY EYECARE GROUP OF SPRING HILL PLLC
Entity type:Organization
Organization Name:PRIMARY EYECARE GROUP OF SPRING HILL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:EILER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-969-3656
Mailing Address - Street 1:5407 MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2499
Mailing Address - Country:US
Mailing Address - Phone:931-489-0029
Mailing Address - Fax:931-489-1033
Practice Address - Street 1:5407 MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2499
Practice Address - Country:US
Practice Address - Phone:931-489-0029
Practice Address - Fax:931-489-1033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2244152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU86169Medicare UPIN
TN6197510001Medicare NSC
3944564Medicare PIN