Provider Demographics
NPI:1457471989
Name:SHAFER VISION CARE PC
Entity Type:Organization
Organization Name:SHAFER VISION CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:OD, FAAO
Authorized Official - Phone:317-852-5000
Mailing Address - Street 1:67 E GARNER RD STE 800
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-7609
Mailing Address - Country:US
Mailing Address - Phone:317-852-5000
Mailing Address - Fax:317-852-5009
Practice Address - Street 1:67 E GARNER RD STE 800
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-7609
Practice Address - Country:US
Practice Address - Phone:317-852-5000
Practice Address - Fax:317-852-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN4813800001OtherRAILROAD MEDICARE
IN4813800001OtherRAILROAD MEDICARE