Healthcare Provider Details

I. General information

NPI: 1881884211
Provider Name (Legal Business Name): EYE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 GRANADA ST
LEAWOOD KS
66211-1453
US

IV. Provider business mailing address

4801 S CLIFF AVE SUITE 100
INDEPENDENCE MO
64055-7015
US

V. Phone/Fax

Practice location:
  • Phone: 816-478-1230
  • Fax:
Mailing address:
  • Phone: 816-478-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MELINDA HAMILTON
Title or Position: ADMIN ASSISTANT
Credential:
Phone: 816-478-1230