Organization
SUBURBAN VISION CARE, INC.
Active
Other names
Suburban Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER W. SHOEMAKER OD (PRESIDENT)
(330) 629-9870
Entity
Organization
Contact information
Practice address
6828 MARKET ST, BOARDMAN, OH 44512-4503
(330) 629-9870
(330) 629-9791
Mailing address
6828 MARKET ST, BOARDMAN, OH 44512-4503
(330) 629-9870
(330) 629-9791
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3497 / T1403
OH
332H00000X
Eyewear Supplier
Primary
152W00000X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000139002
ANTHEM
OH
05
—
2280106
—
OH
01
—
302544644012
MEDICAL MUTUAL
OH
Enumeration date
08/14/2007
Last updated
07/11/2008
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