Provider Demographics
NPI:1699948158
Name:PREMIER EYE CARE, LLC
Entity type:Organization
Organization Name:PREMIER EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAREMBA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:412-926-2657
Mailing Address - Street 1:669 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MT LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1902
Mailing Address - Country:US
Mailing Address - Phone:412-563-1020
Mailing Address - Fax:
Practice Address - Street 1:669 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MT LEBANON
Practice Address - State:PA
Practice Address - Zip Code:15228-1902
Practice Address - Country:US
Practice Address - Phone:412-563-1020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA127606Medicare PIN