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NPI Code Detail

MEDICARE: EYE CARE, INC

MEDICARE: EYE CARE, 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
1332H00000XEyewear Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952474942
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE CARE, INC
Provider Business Mailing Address
First Line : PO BOX 602
Second Line :
City : ZACHARY
State : LA
Zip : 70791-0602
Country : US
Telephone Number : 225-654-3131
Fax Number : 225-654-0791
Provider Business Practice Location Address
First Line : 2421 CHURCH ST
Second Line :
City : ZACHARY
State : LA
Zip : 70791-2710
Country : US
Telephone Number : 225-654-3131
Fax Number : 225-654-0791
Authorized Official
Title or Position : PRESIDENT
Name : DR. GLENN M COULLARD
Credential : O. D.
Telephone Number : 225-654-3131
Provider Enumeration Date : 11/16/2006
Last Update Date : 08/22/2020

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1346209236 — DR. GLENN COULLARD O.D.
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1639258726 — EYE CARE & COSMETIC CENTER, LLC
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1346368412 — EYE CARE AND COSMETIC CENTER, LLC
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Directions to “EYE CARE, INC ” Practice Location

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