Provider Demographics
NPI:1356367981
Name:DENISE M. HARVEY DBA ADVANCED EYECARE
Entity type:Organization
Organization Name:DENISE M. HARVEY DBA ADVANCED EYECARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:573-324-3131
Mailing Address - Street 1:ADVANCED EYE CARE
Mailing Address - Street 2:1310 S. BUS 61
Mailing Address - City:BOWLING GREEN
Mailing Address - State:MO
Mailing Address - Zip Code:63334
Mailing Address - Country:US
Mailing Address - Phone:573-324-3131
Mailing Address - Fax:573-324-6817
Practice Address - Street 1:1420 S BUSINESS 61
Practice Address - Street 2:SUITE F
Practice Address - City:BOWLING GREEN
Practice Address - State:MO
Practice Address - Zip Code:63334-5230
Practice Address - Country:US
Practice Address - Phone:573-324-3131
Practice Address - Fax:573-324-6817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1280700001Medicare NSC
NE5308880001Medicare NSC