Provider Demographics
NPI:1881808202
Name:EYE CARE OPTOMETRY
Entity type:Organization
Organization Name:EYE CARE OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-841-0350
Mailing Address - Street 1:5825 W FORT ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48209-3156
Mailing Address - Country:US
Mailing Address - Phone:313-841-0350
Mailing Address - Fax:313-841-0932
Practice Address - Street 1:5825 W FORT ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48209-3156
Practice Address - Country:US
Practice Address - Phone:313-841-0350
Practice Address - Fax:313-841-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty