Provider Demographics
NPI:1467066811
Name:GREENWOOD VISION CARE LLC
Entity Type:Organization
Organization Name:GREENWOOD VISION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHRISTIE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-987-8720
Mailing Address - Street 1:622 N MADISON AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-4052
Mailing Address - Country:US
Mailing Address - Phone:317-893-4441
Mailing Address - Fax:317-893-4388
Practice Address - Street 1:622 N MADISON AVE STE 9
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-4052
Practice Address - Country:US
Practice Address - Phone:317-893-4441
Practice Address - Fax:317-893-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty