Provider Demographics
NPI:1336322049
Name:FAMILY EYE CARE INC
Entity Type:Organization
Organization Name:FAMILY EYE CARE INC
Other - Org Name:FAMILY EYECARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-352-0616
Mailing Address - Street 1:77 NORMANDY DR
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-1615
Mailing Address - Country:US
Mailing Address - Phone:440-352-0616
Mailing Address - Fax:440-352-0618
Practice Address - Street 1:77 NORMANDY DR
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-1615
Practice Address - Country:US
Practice Address - Phone:440-352-0616
Practice Address - Fax:440-352-0618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152W00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2211627Medicaid
OH9304022Medicare PIN
OH410040653Medicare PIN
OH1258080002Medicare NSC