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PEC SOUTH COUNTY LLC NPI 1295371946


NPI Information

NPI: 1295371946
Provider Name: PEC SOUTH COUNTY LLC
Classification: Optometrist - 152WC0802X
Entity Type: Organization

Specialization: Corneal and Contact Management

Address:
4412 TELEGRAPH RD
SAINT LOUIS, MO
ZIP 63129
Phone: (618) 234-3053
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PEC SOUTH COUNTY LLC is a corneal and contact management optometrist in Saint Louis, MO. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. PEC SOUTH COUNTY LLC NPI is 1295371946. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4412 TELEGRAPH RD
SAINT LOUIS, MO
ZIP 63129-316
Phone: (618) 234-3053

The provider's authorized official is Dirk Massie .
The authorized official title is Optometrist/owner and has the following contact phone number (618) 234-3053.

The enumeration date for this NPI number is 11/18/2019 and was last updated on 11/18/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152WC0802XOptometristCorneal and Contact ManagementYes

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

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