Provider Demographics
NPI:1750349684
Name:NIEMEIER EYECARE INC.
Entity type:Organization
Organization Name:NIEMEIER EYECARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:NIEMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-425-5131
Mailing Address - Street 1:2311 W FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-5118
Mailing Address - Country:US
Mailing Address - Phone:812-425-5131
Mailing Address - Fax:812-425-5132
Practice Address - Street 1:2311 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5118
Practice Address - Country:US
Practice Address - Phone:812-425-5131
Practice Address - Fax:812-425-5132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN4537650001332B00000X
IN18003185A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN4537650001Medicare NSC
IN197510Medicare UPIN