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General NPI Number Information
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NPI Number | 1801101258
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Entity Type | Organization
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Legal Business Name | EYECARE, INC
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 6675 ROBERTS RD
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City | ROBARDS
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State | KY
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Zip | 42452-9772
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Country | US
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Telephone | 270-621-1234
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Fax | 270-521-1111
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Provider Business Mailing Address
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Address Line | 6675 ROBERTS RD
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City | ROBARDS
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State | KY
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Zip | 42452-9772
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Country | US
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Telephone | 270-621-1234
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Fax | 270-521-1111
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SUE ELLEN PUJARI
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Credential |
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Telephone | 270-621-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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