Provider Demographics
NPI:1902506769
Name:E & E EYECARE LLC
Entity type:Organization
Organization Name:E & E EYECARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENFINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:850-313-3367
Mailing Address - Street 1:555 FERN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-4104
Mailing Address - Country:US
Mailing Address - Phone:850-313-3367
Mailing Address - Fax:
Practice Address - Street 1:2944 HIGHWAY 31 W STE 101
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-3003
Practice Address - Country:US
Practice Address - Phone:850-313-3367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Multi-Specialty