Provider Demographics
NPI:1326387358
Name:GREATER CLEVELAND OPTOMETRY LLC
Entity Type:Organization
Organization Name:GREATER CLEVELAND OPTOMETRY LLC
Other - Org Name:BEACHWOOD FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:THATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:216-815-1810
Mailing Address - Street 1:3288 BELVOIR BLVD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-3831
Mailing Address - Country:US
Mailing Address - Phone:216-282-6786
Mailing Address - Fax:
Practice Address - Street 1:3783 GREEN RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5705
Practice Address - Country:US
Practice Address - Phone:216-815-1810
Practice Address - Fax:216-815-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6181152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty