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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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