Provider Demographics
NPI:1033296868
Name:EYE CARE ASSOCIATES OF MARIETTA LLC
Entity Type:Organization
Organization Name:EYE CARE ASSOCIATES OF MARIETTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNDSAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-373-2069
Mailing Address - Street 1:111 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-3111
Mailing Address - Country:US
Mailing Address - Phone:740-373-2069
Mailing Address - Fax:740-336-7887
Practice Address - Street 1:111 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3111
Practice Address - Country:US
Practice Address - Phone:740-373-2069
Practice Address - Fax:740-336-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2410206Medicaid
410035180OtherRAILROAD MEDICARE
OH9309441Medicare PIN
410035180OtherRAILROAD MEDICARE
OHU00283Medicare PIN
OHV06057Medicare UPIN
OH2410206Medicaid