Organization
RIVERSIDE EYE CENTER PC
Active
Organization
RIVERSIDE EYE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN HANTON (MANAGER)
(810) 385-7200
Entity
Organization
Contact information
Practice address
4050 RIVER RD, EAST CHINA, MI 48054-2908
(810) 329-9045
(810) 329-8732
Mailing address
4050 RIVER RD, EAST CHINA, MI 48054-2908
(810) 329-9045
(810) 329-8732
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
MI
332B00000X
Durable Medical Equipment & Medical Supplies
1146090001
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0741045
BCBS INDIVIDUAL PIN
MI
01
—
180G410170
BCBS PIN
MI
Enumeration date
04/16/2007
Last updated
07/25/2025
Update your record
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