Provider Demographics
NPI:1003229303
Name:MILFORD EYE CARE, INC.
Entity Type:Organization
Organization Name:MILFORD EYE CARE, INC.
Other - Org Name:MILFORD EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-965-2020
Mailing Address - Street 1:1107 ALLEN DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-8033
Mailing Address - Country:US
Mailing Address - Phone:513-965-2020
Mailing Address - Fax:513-965-2025
Practice Address - Street 1:1107 ALLEN DR
Practice Address - Street 2:SUITE C
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-8033
Practice Address - Country:US
Practice Address - Phone:513-965-2020
Practice Address - Fax:513-965-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3266152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0432774OtherMEDICARE
OH0324714Medicaid
OH0432774OtherMEDICARE
OH0324714Medicaid