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P-Cor, LLC

Organization Active NPI Optometrist · Dearborn, MI

NPI 1063709137 · NPPES record last updated Apr 2, 2025

Key facts

NPI
1063709137
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
P-COR, LLC
Practice address
5500 Auto Club Dr
Dearborn, MI 48126-2683
Phone
(313) 562-8000
NPI assigned
Jul 8, 2011
Organization subpart
No

Authorized official

Name
Mr. Michael Dunn
Title
Director of Finance
Phone
(248) 577-3624

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 81

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 81

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
P-Cor,LLC
5500 Auto Club Dr, Dearborn, MI 48126-2683 · (313) 562-8000		 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignment
Participating since Jan 1, 1997

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120507000021 MI DME Supplier - Physician - Optometrist 9931194149 Practice locations: Dearborn, MI

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP		 152W00000X Yes
Eyewear Supplier 332H00000X

Addresses

Primary practice location

5500 Auto Club Dr
Dearborn, MI 48126-2683

Mailing address

735 John R Rd Ste 150
Troy, MI 48083-5859
Phone (248) 544-3290

Other providers in Dearborn, MI

All providers in Dearborn, MI · Optometrist in Michigan

Sources for this page

Verify at the official NPI Registry.