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Organization

GREAT LAKES EYE CARE, P.C.

Active
Parent organization
GREAT LAKES EYE CARE, P.C.
Other names
Great Lakes Eye Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
GREAT LAKES EYE CARE, P.C.
Authorized official
MRS. BRENDA S. JACKS B.S. (HUMAN RESOURCES)
(269) 428-3300
Entity
Organization

Contact information

Practice address
570 BROADWAY ST, SOUTH HAVEN, MI 49090-1420
(269) 637-3101
(269) 637-4000
Mailing address
2848 NILES RD, SAINT JOSEPH, MI 49085-3352
(269) 428-3300
(269) 428-5005

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MI

Other

Enumeration date
03/08/2007
Last updated
01/26/2023
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