Provider Demographics
NPI:1285629576
Name:IVES EYECARE CENTER
Entity Type:Organization
Organization Name:IVES EYECARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:FRED
Authorized Official - Last Name:IVES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-733-1918
Mailing Address - Street 1:4465 OLD WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1923
Mailing Address - Country:US
Mailing Address - Phone:724-733-1918
Mailing Address - Fax:724-327-0575
Practice Address - Street 1:4465 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1923
Practice Address - Country:US
Practice Address - Phone:724-733-1918
Practice Address - Fax:724-327-0575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001122152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty