Provider Demographics
NPI:1053809152
Name:LIFETIME EYECARE PC
Entity type:Organization
Organization Name:LIFETIME EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MEIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-884-2020
Mailing Address - Street 1:PO BOX 2073
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122-2073
Mailing Address - Country:US
Mailing Address - Phone:970-884-2020
Mailing Address - Fax:970-884-2977
Practice Address - Street 1:49 MILL STREET
Practice Address - Street 2:
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122
Practice Address - Country:US
Practice Address - Phone:970-884-2020
Practice Address - Fax:970-884-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty