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NPI Code Detail

MEDICARE: PREFERRED EYECARE, INC.

MEDICARE: PREFERRED EYECARE, INC.
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
1152W00000XOptometrist3152MN

General Provider Information

NPI Number : 1578830410
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREFERRED EYECARE, INC.
Provider Business Mailing Address
First Line : PO BOX 942
Second Line :
City : BRAINERD
State : MN
Zip : 56401-0942
Country : US
Telephone Number : 218-829-2607
Fax Number :
Provider Business Practice Location Address
First Line : 7295 GLORY RD
Second Line : WALMART VISION CENTER 1654
City : BAXTER
State : MN
Zip : 56425-7308
Country : US
Telephone Number : 218-829-3848
Fax Number :
Authorized Official
Title or Position : OPTOMETRIST / OWNER
Name : DR. WILLIAM D. HAMMER
Credential : O.D.
Telephone Number : 218-829-2607
Provider Enumeration Date : 11/21/2011
Last Update Date : 11/21/2011

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Directions to “PREFERRED EYECARE, INC. ” Practice Location

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