Provider Demographics
NPI:1184402315
Name:ELITE EYECARE
Entity type:Organization
Organization Name:ELITE EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:LIPE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-353-5964
Mailing Address - Street 1:5300 CENTENNIAL BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1664
Mailing Address - Country:US
Mailing Address - Phone:615-657-5010
Mailing Address - Fax:615-657-4485
Practice Address - Street 1:5300 CENTENNIAL BLVD STE 107
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1664
Practice Address - Country:US
Practice Address - Phone:615-657-5010
Practice Address - Fax:615-657-4485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty