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General NPI Number Information
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NPI Number | 1891846812
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN EYECARE
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/12/2012
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Provider Practice Location Address
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Address Line | 8470 MAIN ST
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City | BIRCH RUN
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State | MI
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Zip | 48415-9704
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Country | US
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Telephone | 989-624-2020
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Fax | 989-624-6257
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Provider Business Mailing Address
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Address Line | 8470 MAIN ST
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City | BIRCH RUN
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State | MI
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Zip | 48415-9704
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Country | US
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Telephone | 989-624-2020
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Fax | 989-624-6257
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Authorized Official
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Title or Position | PHYSICAN
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Name | SUSAN M PERDUE
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Credential | OD
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Telephone | 989-624-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 4901004706
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 4901003182
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License Number State | MI
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