Provider Demographics
NPI:1942476098
Name:SOUTH HILLS EYE CARE ASSOCIATES, L.L.C.
Entity type:Organization
Organization Name:SOUTH HILLS EYE CARE ASSOCIATES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEIRCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-572-9804
Mailing Address - Street 1:12357 S 450 E
Mailing Address - Street 2:#2
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8127
Mailing Address - Country:US
Mailing Address - Phone:801-572-9804
Mailing Address - Fax:801-572-9805
Practice Address - Street 1:12357 S 450 E
Practice Address - Street 2:#2
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8127
Practice Address - Country:US
Practice Address - Phone:801-572-9804
Practice Address - Fax:801-572-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTV07658Medicare UPIN
UTV06462Medicare UPIN