Healthcare Provider Details

I. General information

NPI: 1487627030
Provider Name (Legal Business Name): EYECARE PROFESSIONALS - MOUNTAIN EYEWEAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 W PARK ST
LIVINGSTON MT
59047
US

IV. Provider business mailing address

PO BOX 680 305 W PARK ST
LIVINGSTON MT
59047
US

V. Phone/Fax

Practice location:
  • Phone: 406-222-0250
  • Fax: 406-222-8419
Mailing address:
  • Phone: 406-222-0250
  • Fax: 406-222-8419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: JAMES J BARNEY
Title or Position: PRESIDENT
Credential: OD
Phone: 406-222-0250