=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194825836
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WASHINGTON EYE CARE PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2006
-----------------------------------------------------
Last Update Date | 12/20/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8703 26 MILE RD
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48094-2967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-992-3700
-----------------------------------------------------
Fax | 586-992-3706
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8703 26 MILE RD
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48094-2967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-992-3700
-----------------------------------------------------
Fax | 586-992-3706
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. BARBARA HORN
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 586-992-3700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152WC0802X
-----------------------------------------------------
Taxonomy Name | Corneal and Contact Management Optometrist
-----------------------------------------------------
License Number | 4901003653
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 152WC0802X
-----------------------------------------------------
Taxonomy Name | Corneal and Contact Management Optometrist
-----------------------------------------------------
License Number | 4901004085
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------