Provider Demographics
NPI:1376717017
Name:WESTRICK FAMILY EYE CARE P C
Entity Type:Organization
Organization Name:WESTRICK FAMILY EYE CARE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:WESTRICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:260-244-7542
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-0187
Mailing Address - Country:US
Mailing Address - Phone:260-244-7542
Mailing Address - Fax:260-244-4638
Practice Address - Street 1:513 N LINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1229
Practice Address - Country:US
Practice Address - Phone:260-244-7542
Practice Address - Fax:260-244-4638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002764A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000631685OtherBCBS
INDP5455OtherRAILROAD MEDICARE
IN5213022OtherAETNA
IN5577580001Medicare NSC
IN5213022OtherAETNA