Provider Demographics
NPI:1154495273
Name:UNION EYE CARE CENTER, INC.
Entity Type:Organization
Organization Name:UNION EYE CARE CENTER, INC.
Other - Org Name:UNION EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR. OF ADMINISTRATION & GROUP SALE
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PREISZIG
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:216-986-9700
Mailing Address - Street 1:4750 BEIDLER RD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4604
Mailing Address - Country:US
Mailing Address - Phone:216-986-9700
Mailing Address - Fax:216-986-1996
Practice Address - Street 1:9571 VISTA WAY
Practice Address - Street 2:
Practice Address - City:GARFIELD HTS.
Practice Address - State:OH
Practice Address - Zip Code:44125
Practice Address - Country:US
Practice Address - Phone:216-663-4060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNION EYE CARE CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3516SC332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0478600003Medicare ID - Type Unspecified