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
1991 PARK AVE W, ONTARIO, OH 44906-2233
(419) 756-8000
Mailing address
466 S TRIMBLE RD, MANSFIELD, OH 44906-3416
(419) 756-8000
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
10/22/2024
Last updated
10/22/2024
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