Organization
STACY G. PASCH, O.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY PASCH RELLINGER O.D. (OWNER)
(419) 333-9638
Entity
Organization
Contact information
Practice address
2355 HAYES AVE, FREMONT, OH 43420-2634
(419) 333-9638
(419) 332-0168
Mailing address
2355 HAYES AVE, FREMONT, OH 43420-2634
(419) 333-9638
(419) 332-0168
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4960
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000339206
OHIO BLUE CROSS BLUESHIEL
OH
05
—
2321875
—
OH
01
—
28482346004
MEDICAL MUTUAL OF OHIO
OH
01
—
9331911
MEDICARE GROUP PIN
OH
01
—
DA9205
RAILROAD MEDICARE GRP NUM
—
01
—
P00078028
RAILROAD MEDICARE PIN
—
Enumeration date
07/14/2005
Last updated
01/30/2008
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