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NPI Code Detail

MEDICARE: EYE ON HEALTH CO LLC

MEDICARE: EYE ON HEALTH CO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

General Provider Information

NPI Number : 1053786145
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE ON HEALTH CO LLC
Provider Business Mailing Address
First Line : 9305 W THOMAS RD STE 300
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-3366
Country : US
Telephone Number : 480-809-0550
Fax Number : 623-321-6314
Provider Business Practice Location Address
First Line : 9305 W THOMAS RD STE 300
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-3366
Country : US
Telephone Number : 480-809-0550
Fax Number : 623-321-6314
Authorized Official
Title or Position : BILLER
Name : AMANDA GREENSTREET
Credential :
Telephone Number : 480-459-1944
Provider Enumeration Date : 12/01/2015
Last Update Date : 11/21/2025

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Directions to “EYE ON HEALTH CO LLC ” Practice Location

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