Provider Demographics
NPI:1336202258
Name:WEST COAST EYE CARE INC
Entity Type:Organization
Organization Name:WEST COAST EYE CARE INC
Other - Org Name:WEST COAST EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHID
Authorized Official - Middle Name:
Authorized Official - Last Name:AOUCHICHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-466-3111
Mailing Address - Street 1:15640 NEW HAMPSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4168
Mailing Address - Country:US
Mailing Address - Phone:239-466-3111
Mailing Address - Fax:239-466-9499
Practice Address - Street 1:15640 NEW HAMPSHIRE CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4168
Practice Address - Country:US
Practice Address - Phone:239-466-3111
Practice Address - Fax:239-466-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4807300001Medicare NSC
FLK3967Medicare PIN