Provider Demographics
NPI:1114327608
Name:INDY EYE CARE LLC
Entity Type:Organization
Organization Name:INDY EYE CARE LLC
Other - Org Name:NORA EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-219-2238
Mailing Address - Street 1:616 LEXINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2256
Mailing Address - Country:US
Mailing Address - Phone:812-219-2238
Mailing Address - Fax:
Practice Address - Street 1:860 E 86TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-6859
Practice Address - Country:US
Practice Address - Phone:317-848-7755
Practice Address - Fax:317-848-7766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-03
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003774A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty