Provider Demographics
NPI:1063125458
Name:MCCARTHY COMPLETE EYE CARE PLLC
Entity type:Organization
Organization Name:MCCARTHY COMPLETE EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:952-356-3544
Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636-0747
Mailing Address - Country:US
Mailing Address - Phone:763-746-2094
Mailing Address - Fax:240-317-5185
Practice Address - Street 1:3601 HIGHWAY 100 S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2500
Practice Address - Country:US
Practice Address - Phone:952-356-3544
Practice Address - Fax:240-317-5185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty