Provider Demographics
NPI:1700985678
Name:FAMILY EYE CARE CENTER, PC
Entity type:Organization
Organization Name:FAMILY EYE CARE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BIERLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-652-2626
Mailing Address - Street 1:12009 N SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458-1581
Mailing Address - Country:US
Mailing Address - Phone:810-686-3540
Mailing Address - Fax:810-686-3772
Practice Address - Street 1:12009 N SAGINAW ST
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:MI
Practice Address - Zip Code:48458-1581
Practice Address - Country:US
Practice Address - Phone:810-686-3540
Practice Address - Fax:810-686-3772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002349152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0304620003Medicare NSC
MI0G37690Medicare PIN