Beavers Eye Care, Inc.
Organization Active NPI Optometrist · Rogers, AR
NPI 1184889040 · NPPES record last updated Jul 21, 2008
Key facts
- NPI
- 1184889040
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 2596 (AR)
- Legal business name
- BEAVERS EYE CARE, INC.
- Practice address
- 4208 Pleasant Crossing Blvd
Rogers, AR 72758-1345 - Phone
- (479) 631-2030
- Fax
- (479) 631-1530
- NPI assigned
- Jul 21, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Justin Beavers, O.D.
- Title
- President
- Phone
- (479) 631-2030
Practitioners 1
-
Justin Ryan Beavers, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100831000632 | AR | Part B Supplier - Clinic/Group Practice | 6103940994 |
Receives reassigned benefits from 1 practitioner Practice locations: Rogers, AR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 2596 | AR | Yes |
Addresses
Primary practice location
4208 Pleasant Crossing Blvd
Rogers, AR 72758-1345
Mailing address
3167 N Katherine Ave
Fayetteville, AR 72703-6523
Phone (479) 631-2030
Other names
- Beavers Eye Care
Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.