Healthcare Provider Details
I. General information
NPI: 1346489747
Provider Name (Legal Business Name): EYE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/10/2009
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11010 HASKELL AVE
KANSAS CITY KS
66109-8500
US
IV. Provider business mailing address
4801 S CLIFF AVE SUITE 100
INDEPENDENCE MO
64055-7015
US
V. Phone/Fax
- Phone: 816-478-1230
- Fax: 816-478-4413
- Phone: 816-478-1230
- Fax: 816-478-4413
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | 089800000000385 |
| License Number State | KS |
VIII. Authorized Official
Name: MS.
MELINDA
HAMILTON
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 816-350-4536