Eyecare Indiana Ll, PC

Optometrist in South Bend, IN. Organization (NPI-2).

NPI number1447516604

StatusActive

Last updated in NPPESApr 2, 2012

Details

NPI: 1447516604
Entity type: Organization (NPI-2)
Legal business name: Eyecare Indiana Ll, PC
Organization subpart: No
Enumeration date: Apr 2, 2012
Last updated: Apr 2, 2012

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
152W00000X	Optometrist	–	–	Yes

Other names

C&B Optical One (Doing Business As)

Practice location

4121 S. Michigan Street
South Bend, IN 46614-2545

Phone 574-291-9200 · Fax 574-299-4423

Mailing address

4121 S. Michigan Street
South Bend, IN 46614-2545

Phone 574-291-9200 · Fax 574-299-4423

Authorized official

Terri Peschke
C.O.O.
5742919200

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Optometrist providers in South Bend, IN

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