Organization
INDIANA UNIVERSITY
Active
Other names
Community Eye Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER S FISHER (BUSINESS MGR)
(812) 856-3624
Entity
Organization
Contact information
Practice address
803 N MONROE ST, BLOOMINGTON, IN 47404-3321
(812) 855-1671
(812) 855-5157
Mailing address
803 N MONROE ST, BLOOMINGTON, IN 47404-3321
(812) 855-1671
(812) 855-5157
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000105528
ANTHEM
IN
05
—
100184630 A
—
IN
Enumeration date
06/14/2006
Last updated
09/20/2011
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