MEDICARE: EYEWEAR DETROIT COMPANY

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
1	152W00000X	Optometrist	4901004205	MI

General Provider Information

NPI Number	:	1871027409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYEWEAR DETROIT COMPANY

Provider Business Mailing Address
First Line	:	6466 SHAPPIE RD
Second Line	:
City	:	CLARKSTON
State	:	MI
Zip	:	48348-1960
Country	:	US
Telephone Number	:	248-396-2214
Fax Number	:

Provider Business Practice Location Address
First Line	:	48187 VAN DYKE AVE
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48317-3268
Country	:	US
Telephone Number	:	586-739-9550
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. DARREN SMARCH
Credential	:	O.D.
Telephone Number	:	586-739-9550

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	02/24/2025

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Directions to “EYEWEAR DETROIT COMPANY ” Practice Location

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