Provider Demographics
NPI:1437243573
Name:EYECARE ASSOCIATES OF BLUFFTON, LLP
Entity Type:Organization
Organization Name:EYECARE ASSOCIATES OF BLUFFTON, LLP
Other - Org Name:EYECARE ASSOCIATES OF ROANOKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-824-2020
Mailing Address - Street 1:980 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-1316
Mailing Address - Country:US
Mailing Address - Phone:260-824-2020
Mailing Address - Fax:260-824-4121
Practice Address - Street 1:980 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-1316
Practice Address - Country:US
Practice Address - Phone:260-824-2020
Practice Address - Fax:260-824-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100389250Medicaid
IN100389250Medicaid
IN227810Medicare ID - Type Unspecified