National Provider Identifier Database

THREE RIVERS EYECARE PC
Eyewear Supplier

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.


Contact Information

THREE RIVERS EYECARE PC
123 S FAIR STREET
OTSEGO, MI49078
Phone: 269-694-9462
Fax: 269-694-5826
Website:
Specialty Taxonomy Code
* Eyewear Supplier 332H00000X

* Indicates primary specialty

NPI Profile & details for THREE RIVERS EYECARE PC

NPI Number 1497812150
Legal business name
LBN
THREE RIVERS EYECARE PC
Authorized official MICHAEL SUSSEX - (PRESIDENT OWNER)
Entity Organization
Organization subpart Yes
Enumeration date 01/02/2007
Last updated 07/20/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • MI Medicaid: 944696853
  • MI Medicaid: 945191120
  • MI Other: 900G510070 BCBS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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