Provider Demographics
NPI:1124419957
Name:PRAIRIE VIEW EYE CARE, LLC
Entity type:Organization
Organization Name:PRAIRIE VIEW EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MOSIER ESLIT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:785-410-2992
Mailing Address - Street 1:2900 AMHERST AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-3043
Mailing Address - Country:US
Mailing Address - Phone:785-477-0861
Mailing Address - Fax:
Practice Address - Street 1:2900 AMHERST AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-3043
Practice Address - Country:US
Practice Address - Phone:785-477-0861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1986152WC0802X, 152WL0500X, 152WV0400X, 152WX0102X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1003196882Medicaid
KS1003196882Medicaid
KS1003196882Medicare NSC
KS1003196882Medicare PIN
KS1003196882Medicare Oscar/Certification