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Pcor LLC

Organization Active NPI Optometrist · Lake Orion, MI

NPI 1598931925 · NPPES record last updated Jan 22, 2018

Key facts

NPI
1598931925
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
PCOR LLC
Practice address
684 S Lapeer Rd
Lake Orion, MI 48362-2918
Phone
(248) 693-3380
Fax
(248) 307-9518
NPI assigned
May 6, 2008
Organization subpart
No

Authorized official

Name
Mrs. Gail Elias
Title
VP
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).

Corporate family (same tax ID) 25

Organizations that report the same tax identification number in the National Provider Directory.

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20101006000050 MI DME Supplier - Physician - Optometrist 9931194149 Practice locations: Lake Orion, MI

National Provider Directory

Tax ID family
P-Cor LLC (26 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

684 S Lapeer Rd
Lake Orion, MI 48362-2918

Mailing address

735 John R Rd Ste 150
Troy, MI 48083-5859
Phone (248) 588-9300

Other providers in Lake Orion, MI

All providers in Lake Orion, MI · Optometrist in Michigan

Sources for this page

Verify at the official NPI Registry.