Provider Demographics
NPI:1871607085
Name:AUTHIER/MILLER EYECARE CENTER, L.L.C.
Entity type:Organization
Organization Name:AUTHIER/MILLER EYECARE CENTER, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:JIMMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-371-8230
Mailing Address - Street 1:123 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NE
Mailing Address - Zip Code:68771-5505
Mailing Address - Country:US
Mailing Address - Phone:402-337-0375
Mailing Address - Fax:402-337-0377
Practice Address - Street 1:123 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NE
Practice Address - Zip Code:68771-5505
Practice Address - Country:US
Practice Address - Phone:402-337-0375
Practice Address - Fax:402-337-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty