Provider Demographics
NPI:1801101258
Name:EYECARE, INC
Entity type:Organization
Organization Name:EYECARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:PUJARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-621-1234
Mailing Address - Street 1:6675 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:ROBARDS
Mailing Address - State:KY
Mailing Address - Zip Code:42452-9772
Mailing Address - Country:US
Mailing Address - Phone:270-621-1234
Mailing Address - Fax:270-521-1111
Practice Address - Street 1:6675 ROBERTS RD
Practice Address - Street 2:
Practice Address - City:ROBARDS
Practice Address - State:KY
Practice Address - Zip Code:42452-9772
Practice Address - Country:US
Practice Address - Phone:270-621-1234
Practice Address - Fax:270-521-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital