Provider Demographics
NPI:1013181940
Name:MATTHIAS HELFRICH O.D. INC
Entity Type:Organization
Organization Name:MATTHIAS HELFRICH O.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HELFRICH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-366-6700
Mailing Address - Street 1:1027 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6303
Mailing Address - Country:US
Mailing Address - Phone:440-366-6700
Mailing Address - Fax:440-365-3939
Practice Address - Street 1:1027 E BROAD ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6303
Practice Address - Country:US
Practice Address - Phone:440-366-6700
Practice Address - Fax:440-365-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3672332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0118438Medicaid
OH0573800001Medicare NSC
OHT47933Medicare UPIN
OH0118438Medicaid