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Contact Information

CROSSTOWN EYECARE LLC
990 S MARION ST
MARTINSVILLE, IN46151-2438
 Phone: 765-342-5497
 Fax: 765-349-1922
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for CROSSTOWN EYECARE LLC

NPI Number 1619148145
LBN Legal business name CROSSTOWN EYECARE LLC
Authorized official D. MOODY - (MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/12/2008
Last updated 12/14/2010 - About 15 years ago
Identifiers
IN License # 18001808B
IN Medicaid 23091
IN Other 4434 DAVIS VISION
IN Other IN1808 EYEMED
IN Other 02875 SPECTERA
IN Other 7653425497 VISION SERVICE PLAN
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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