Provider Demographics
NPI:1265858294
Name:EYE Q EYECARE INC
Entity Type:Organization
Organization Name:EYE Q EYECARE INC
Other - Org Name:DAVID LITTLEJOHN O.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:LITTLEJOHN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-606-2772
Mailing Address - Street 1:8090 LOONEY RD. STE. B
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356
Mailing Address - Country:US
Mailing Address - Phone:937-606-2772
Mailing Address - Fax:937-916-3206
Practice Address - Street 1:8090 LOONEY RD. STE. B
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356
Practice Address - Country:US
Practice Address - Phone:937-606-2772
Practice Address - Fax:937-916-3206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4367332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7047770001Medicare NSC