Elite Eyecare Center PLLC
Organization Active NPI Optometrist · Thatcher, AZ
NPI 1982102844 · NPPES record last updated Jun 11, 2019
Key facts
- NPI
- 1982102844
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- ELITE EYECARE CENTER PLLC
- Practice address
- 3383 W. Main St.
Thatcher, AZ 85552 - Phone
- (928) 792-4455
- Fax
- (928) 792-4463
- NPI assigned
- Jan 25, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert Scott Sellers, OD
- Title
- Optometrist
- Phone
- (928) 792-4455
Practitioners 3
-
Robert Scott Sellers, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180611002521 | AZ | Part B Supplier - Clinic/Group Practice | 2961757141 |
Receives reassigned benefits from 3 practitioners Practice locations: Thatcher, AZ |
National Provider Directory
Locations
3383 W Main St
Thatcher, AZ 85552
Phone (928) 298-0346
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
3383 W. Main St.
Thatcher, AZ 85552
Mailing address
3383 W. Main St.
Thatcher, AZ 85552-5558
Phone (928) 792-4455
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 352532 | Medicaid | AZ |
Other providers in Thatcher, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2019. 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.