1821101700 NPI number — H J EYECARE INC

Table of content: (NPI 1821101700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821101700 NPI number — H J EYECARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H J EYECARE INC
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:
1821101700
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 636161
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-6161
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-721-6781
Provider Business Mailing Address Fax Number:
513-322-7989

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7371 BRANDT PIKE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
HUBER HEIGHTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45424-3275
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-233-9000
Provider Business Practice Location Address Fax Number:
937-233-9452
Provider Enumeration Date:
08/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JOSHI
Authorized Official First Name:
HIMANSHU
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
937-233-9000

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  34006852J , 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: 0007987243 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2180081 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: DC5553 . This is a "RR MEDICARE GROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0802032 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 147642469-003 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 274852 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2882788 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 147642469 . This is a "TRICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 147642469-00 . This is a "OHIO BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 78954 . This is a "NATIONWIDE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: P00176227 . This is a "RR MCR INDIVIDUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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