Organization
ADRIAN EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY JACKSON (CREDENTIALING)
(517) 202-1618
Entity
Organization
Contact information
Practice address
580 RIVERSIDE AVE, ADRIAN, MI 49221-1543
(517) 265-6055
(517) 265-6115
Mailing address
580 RIVERSIDE AVE, ADRIAN, MI 49221-1543
(517) 265-6055
(517) 265-6115
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
4901002974
MI
332H00000X
Eyewear Supplier
4901004286
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5276880001
DMERC
MI
05
—
864639178
—
MI
Enumeration date
11/14/2006
Last updated
05/08/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us