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Organization

JOYCE C PECK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOYCE C PECK (OPTICIAN)
(606) 564-8794
Entity
Organization

Contact information

Practice address
1937 OLD MAIN ST, STE 2, MAYSVILLE, KY 41056-8956
(606) 759-7311
(606) 759-0610
Mailing address
PO BOX 54, WASHINGTON, KY 41096-0054
(606) 564-8794
(606) 759-0610

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
941
KY
332H00000X
Eyewear Supplier
079545
KY
332H00000X
Eyewear Supplier
Primary
2826372
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000537045
BCBS
KY
05
4295
KY
05
4296
KY
05
5200015500
KY
05
5200016300
KY
05
5280097600
KY
05
5290396000
KY
05
7100022560
KY
Enumeration date
03/02/2007
Last updated
01/31/2018
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