Provider Demographics
NPI:1003886201
Name:EYE TEAM, INC.
Entity Type:Organization
Organization Name:EYE TEAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-625-6090
Mailing Address - Street 1:1200 PROSPECT ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-3362
Mailing Address - Country:US
Mailing Address - Phone:419-625-6090
Mailing Address - Fax:419-626-8621
Practice Address - Street 1:1200 PROSPECT ST
Practice Address - Street 2:SUITE 105
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3316
Practice Address - Country:US
Practice Address - Phone:419-625-6090
Practice Address - Fax:419-626-8621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2275943Medicaid
OH0403180001Medicare NSC