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Organization

C AND G EYECARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY E CONTNER O.D. (OWNER)
(937) 599-5315
Entity
Organization

Contact information

Practice address
1008 N MAIN ST, BELLEFONTAINE, OH 43311-2371
(937) 599-5315
(937) 599-1185
Mailing address
1008 N MAIN ST, BELLEFONTAINE, OH 43311-2371
(937) 599-5315
(937) 599-1185

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
3526
OH
152WC0802X
Corneal and Contact Management Optometrist
4696
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0215387
OH
05
0566105
OH
01
CO0505491
PALMETTO GBA
01
GA0793641
PALMETTO GBA
OH
01
P00221595
UNITED HEALTHCARE RAILROAD MEDICARE
OH
Enumeration date
03/06/2008
Last updated
07/02/2008
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