1154871119 NPI number — LOHMAN EYE CARE ASSOCIATES

Table of content: MRS. LORI KAY ZOUCHA LMHC (NPI 1003226812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154871119 NPI number — LOHMAN EYE CARE ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOHMAN EYE CARE ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154871119
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2700 SANDY LAKE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAVENNA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44266-8208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-688-8811
Provider Business Mailing Address Fax Number:
330-688-9550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3330 KENT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STOW
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44224-4537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-688-8811
Provider Business Practice Location Address Fax Number:
330-688-9550
Provider Enumeration Date:
10/13/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOHMAN
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OPTOMETRIST
Authorized Official Telephone Number:
330-688-8811

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  3133 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2275396 OH , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 298421012 . This is a "BUCKEYE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".