Provider Demographics
NPI:1366822363
Name:UNION EYES OPTICAL INC
Entity Type:Organization
Organization Name:UNION EYES OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:REMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-759-7846
Mailing Address - Street 1:229 CHURCHILL HUBBARD RD STE B
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1324
Mailing Address - Country:US
Mailing Address - Phone:330-759-7846
Mailing Address - Fax:
Practice Address - Street 1:229 CHURCHILL HUBBARD RD STE B
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1324
Practice Address - Country:US
Practice Address - Phone:330-759-7846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2016-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3257152W00000X
OH3166152W00000X
OH4851152W00000X
OH3433152W00000X
OH6472152W00000X
OHS5193156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0322252Medicaid
OH3112607Medicaid
OH2023563Medicaid
OH0399911Medicaid
OH2572916Medicaid