Provider Demographics
NPI:1467528182
Name:BARBERTON EYE CENTER, LLC
Entity Type:Organization
Organization Name:BARBERTON EYE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-745-4404
Mailing Address - Street 1:31 CONSERVATORY DR
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4281
Mailing Address - Country:US
Mailing Address - Phone:330-745-4404
Mailing Address - Fax:330-753-9162
Practice Address - Street 1:150 SPRINGSIDE DR
Practice Address - Street 2:SUITE C300
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2468
Practice Address - Country:US
Practice Address - Phone:330-666-0707
Practice Address - Fax:330-668-4884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2138663Medicaid
OH0266520003Medicare NSC