Provider Demographics
NPI:1245416155
Name:OSCEOLA VISION CENTER P.C.
Entity Type:Organization
Organization Name:OSCEOLA VISION CENTER P.C.
Other - Org Name:OTTUMWA EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CASH
Authorized Official - Last Name:HOACLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:641-682-9816
Mailing Address - Street 1:103 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2542
Mailing Address - Country:US
Mailing Address - Phone:641-774-7507
Mailing Address - Fax:641-774-0466
Practice Address - Street 1:103 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2542
Practice Address - Country:US
Practice Address - Phone:641-682-9816
Practice Address - Fax:641-682-4690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0277610004Medicare NSC