Organization
OHIO EYE OPTOMETRIC, LLC
Active
Organization
OHIO EYE OPTOMETRIC, LLC
Active
Parent organization
OHIO EYE OPTOMETRIC, LLC
Other names
OEO Optical
Organization subpart
Yes
Provider details
NPI number
Legal business name
OHIO EYE OPTOMETRIC, LLC
Authorized official
STACY ELLIS (CREDENTIALING SPECIALIST)
(419) 774-3402
Entity
Organization
Contact information
Practice address
110 COSHOCTON AVE STE C, MOUNT VERNON, OH 43050-2628
(419) 756-8000
(419) 756-2601
Mailing address
466 S TRIMBLE RD, MANSFIELD, OH 44906-3416
(419) 756-8000
(419) 756-2601
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S3838
NON MEDICARE
OH
Enumeration date
02/20/2025
Last updated
02/20/2025
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