Provider Demographics
NPI:1194818864
Name:SHAMROCK FAMILY EYE CARE INC
Entity Type:Organization
Organization Name:SHAMROCK FAMILY EYE CARE INC
Other - Org Name:DRS BOLTZ AND RENGERT INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DELMORE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-889-8331
Mailing Address - Street 1:5151 POST RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1245
Mailing Address - Country:US
Mailing Address - Phone:614-889-8331
Mailing Address - Fax:614-760-0256
Practice Address - Street 1:5151 POST RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017
Practice Address - Country:US
Practice Address - Phone:614-889-8331
Practice Address - Fax:614-760-0256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0521990001Medicare NSC
OH9279851Medicare PIN