FAMILY & PEDIATRIC EYE CARE PLC NPI 1417137084

NPI Information

NPI: 1417137084
Provider Name: FAMILY & PEDIATRIC EYE CARE PLC
Classification: Optometrist - 152WP0200X
Entity Type: Organization

Specialization: Pediatrics

Address:
144 MONROE CENTER
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 459-0641
Get Directions

FAMILY & PEDIATRIC EYE CARE PLC is a pediatrics optometrist in Grand Rapids, MI. The provider is optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children. FAMILY & PEDIATRIC EYE CARE PLC NPI is 1417137084. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

144 MONROE CENTER
GRAND RAPIDS, MI
ZIP 49503-802
Phone: (616) 459-0641
Fax: (616) 459-0621

The provider's authorized official is Gene Ernest Fonger .
The authorized official title is Store Owner and has the following contact phone number (616) 459-0641.

The enumeration date for this NPI number is 11/12/2007 and was last updated on 6/30/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152WC0802X	Optometrist	Corneal and Contact Management	4901002505	MICHIGAN	No
2	152WV0400X	Optometrist	Vision Therapy	4901004219	MICHIGAN	No
3	152WP0200X	Optometrist	Pediatrics	4901004219	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	900D114840	OTHER	MICHIGAN	BCBS PIN #
2	U92856	OTHER	MICHIGAN	UPIN
3	5041964	MEDICAID	MICHIGAN
4	P19680002	MEDICARE PIN	MICHIGAN
5	900D114850	OTHER	MICHIGAN	BCBS PIN #
6	5474550001	MEDICARE NSC	MICHIGAN
7	P19680001	MEDICARE PIN	MICHIGAN
8	0P19680	OTHER	MICHIGAN	MEDICARE GROUP NUMBER
9	T33048	OTHER	MICHIGAN	UPIN
10	4599036	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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