Provider Demographics
NPI:1952563744
Name:PRIMARY EYECARE, PLC
Entity type:Organization
Organization Name:PRIMARY EYECARE, PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTEE
Authorized Official - Middle Name:
Authorized Official - Last Name:NANJI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:901-867-5540
Mailing Address - Street 1:11860 CRANSTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4886
Mailing Address - Country:US
Mailing Address - Phone:901-867-5540
Mailing Address - Fax:901-867-5575
Practice Address - Street 1:11860 CRANSTON DRIVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-4886
Practice Address - Country:US
Practice Address - Phone:901-867-5540
Practice Address - Fax:901-867-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2510152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN35900661Medicare PIN