Provider Demographics
NPI:1023212040
Name:OPTIMUM EYE CARE, INC
Entity Type:Organization
Organization Name:OPTIMUM EYE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:T
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-382-4933
Mailing Address - Street 1:P.O.BOX 910
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-1996
Mailing Address - Country:US
Mailing Address - Phone:937-382-4933
Mailing Address - Fax:937-383-1336
Practice Address - Street 1:2079 ROMBACH AVE.
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-1996
Practice Address - Country:US
Practice Address - Phone:937-382-4933
Practice Address - Fax:937-383-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5376152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0398350001Medicare NSC
OH0398350001Medicare NSC