Provider Demographics
NPI:1396569323
Name:AE EYECARE
Entity type:Organization
Organization Name:AE EYECARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-414-8883
Mailing Address - Street 1:409 LOTUS CT
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-9840
Mailing Address - Country:US
Mailing Address - Phone:336-712-4733
Mailing Address - Fax:336-712-4704
Practice Address - Street 1:6270 TOWNCENTER DR
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9376
Practice Address - Country:US
Practice Address - Phone:336-712-4733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-15
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty