Provider Demographics
NPI:1225395510
Name:PRICE EYE CARE, INC
Entity Type:Organization
Organization Name:PRICE EYE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:PRICE
Authorized Official - Last Name:KOWALESKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-402-0222
Mailing Address - Street 1:PO BOX 604
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-0604
Mailing Address - Country:US
Mailing Address - Phone:317-402-0222
Mailing Address - Fax:
Practice Address - Street 1:946 N STATE ST
Practice Address - Street 2:SUITE B
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-1202
Practice Address - Country:US
Practice Address - Phone:317-402-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003178A/B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty