1811475031 NPI number — C&H FAMILY EYECARE,LLC DBA DEERFIELD VISION CENTER

Table of content: (NPI 1811475031)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811475031 NPI number — C&H FAMILY EYECARE,LLC DBA DEERFIELD VISION CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
C&H FAMILY EYECARE,LLC DBA DEERFIELD VISION CENTER
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:
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:
1811475031
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
726 E MAIN ST STE F
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEBANON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45036-1900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-520-9521
Provider Business Mailing Address Fax Number:
513-228-0790

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9554 S MASON MONTGOMERY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MASON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45040-9759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-520-9521
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2018

Additional Information

Authorized Official

Authorized Official Last Name:
CARAFICE
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
513-520-9521

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  4256-T1271 , 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)





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