Provider Demographics
NPI:1447421870
Name:SCIOTO EYE CARE
Entity Type:Organization
Organization Name:SCIOTO EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PERIGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-491-1225
Mailing Address - Street 1:3653 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-4009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:614-491-6810
Practice Address - Street 1:3653 S HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-4009
Practice Address - Country:US
Practice Address - Phone:614-491-1225
Practice Address - Fax:614-491-6810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5332152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU90599Medicare UPIN
OH4085111Medicare PIN
OH9325391Medicare PIN