| Eye Clinic,llc | |
|
9151 Estate Thomas Foothills Professional Bld#107 St. Thomas VI 00802 | |
| (340) 774-1531 | |
| (340) 774-1517 |
| Full Name | Eye Clinic,llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9151 Estate Thomas, St. Thomas, Virgin Island |
| Authorized Official Name and Position | Kidane H Assefa (OWNER) |
| Authorized Official Contact | 3407741531 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eye Clinic,llc Po Box 302682 St. Thomas VI 00803 Ph: (340) 774-1531 | Eye Clinic,llc 9151 Estate Thomas Foothills Professional Bld#107 St. Thomas VI 00802 Ph: (340) 774-1531 |
| NPI Number | 1316186737 |
|---|---|
| Provider Enumeration Date | 02/09/2009 |
| Last Update Date | 12/06/2012 |
| Medicare PECOS PAC ID | 3678726361 |
|---|---|
| Medicare Enrollment ID | O20130108000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316186737 | NPI | - | NPPES |
| 1720185184 | Other | VI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | VI1290 (Virgin Island) | Primary |
| Provider Name | Kidane Assefa |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1720185184 PECOS PAC ID: 7810957867 Enrollment ID: I20041013001278 |
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