Provider Demographics
NPI:1417551193
Name:WASHINGTON EYE CARE CENTER
Entity Type:Organization
Organization Name:WASHINGTON EYE CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-668-0000
Mailing Address - Street 1:221 N 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-2203
Mailing Address - Country:US
Mailing Address - Phone:319-653-4558
Mailing Address - Fax:319-653-2574
Practice Address - Street 1:100 W STATE ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:IA
Practice Address - Zip Code:52361-4709
Practice Address - Country:US
Practice Address - Phone:319-668-8000
Practice Address - Fax:319-668-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty