| Elevated Eye Care Inc | |
|
917 Jonesboro Rd Ste A Mcdonough GA 30253-6031 | |
| (770) 914-3399 | |
| (770) 914-3334 |
| Full Name | Elevated Eye Care Inc |
|---|---|
| Speciality | Optometrist |
| Location | 917 Jonesboro Rd Ste A, Mcdonough, Georgia |
| Authorized Official Name and Position | Santrell Hart-moreland (PRESIDENT) |
| Authorized Official Contact | 7709143399 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevated Eye Care Inc 917 Jonesboro Rd Ste A Mcdonough GA 30253-6031 Ph: (770) 914-3399 | Elevated Eye Care Inc 917 Jonesboro Rd Ste A Mcdonough GA 30253-6031 Ph: (770) 914-3399 |
| NPI Number | 1730332370 |
|---|---|
| Provider Enumeration Date | 10/28/2008 |
| Last Update Date | 06/14/2022 |
| Medicare PECOS PAC ID | 1254471857 |
|---|---|
| Medicare Enrollment ID | O20091211000453 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730332370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1761 (Georgia) | Secondary |
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Ayana C Robateau |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114180155 PECOS PAC ID: 9436217072 Enrollment ID: I20081025000033 |
| Provider Name | Santrell D Hart Moreland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376613968 PECOS PAC ID: 2567502156 Enrollment ID: I20091211000458 |
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