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Contact Information

OPTOMETRIC EYECARE INC.
303 E MAIN ST
OLNEY, IL62450
 Phone: 618-395-2676
 Fax: 618-395-2720
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Health Service

261QH0100X
Indicates primary specialty

NPI Profile & details for OPTOMETRIC EYECARE INC.

NPI Number 1609041342
LBN Legal business name OPTOMETRIC EYECARE INC.
Authorized official CLARK DESHON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 04/24/2008
Last updated 08/31/2018 - About 8 years ago
Identifiers
IL License # 046-008793
IL License # 3840-6969
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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