Provider Demographics
NPI:1114684610
Name:NORMAN EYECARE LTD
Entity Type:Organization
Organization Name:NORMAN EYECARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-564-2800
Mailing Address - Street 1:501 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IN
Mailing Address - Zip Code:47960-2006
Mailing Address - Country:US
Mailing Address - Phone:574-583-9311
Mailing Address - Fax:
Practice Address - Street 1:501 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IN
Practice Address - Zip Code:47960-2006
Practice Address - Country:US
Practice Address - Phone:574-583-9311
Practice Address - Fax:765-564-2477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty