Healthcare Provider Details

I. General information

NPI: 1609066034
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: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 S COMMERCIAL ST
HARRISONVILLE MO
64701
US

IV. Provider business mailing address

670 S COMMERCIAL ST
HARRISONVILLE MO
64701-1282
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 Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MELINDA HAMILTON
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 816-350-4536