Organization
P-COR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL ELIAS (VP)
(248) 588-9300
Entity
Organization
Contact information
Practice address
3271 UNION LAKE RD, COMMERCE TOWNSHIP, MI 48382-4550
(248) 360-0121
(248) 360-9007
Mailing address
735 JOHN R RD STE 150, TROY, MI 48083-5859
(248) 588-9300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0M30440
MEDICARE PTAN
MI
01
—
1141070051
PTAN
MI
Enumeration date
03/12/2015
Last updated
01/23/2020
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