Provider Demographics
NPI:1467572602
Name:SWARTZ FAMILY EYECARE, LLC
Entity Type:Organization
Organization Name:SWARTZ FAMILY EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOPLEK-SWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-593-1766
Mailing Address - Street 1:2150 EWING CRAWFIS CIR
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-9042
Mailing Address - Country:US
Mailing Address - Phone:937-593-1766
Mailing Address - Fax:937-593-1557
Practice Address - Street 1:2150 EWING CRAWFIS CIR
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-9042
Practice Address - Country:US
Practice Address - Phone:937-593-1766
Practice Address - Fax:937-593-1557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4598152W00000X
OH4596152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2499934Medicaid
OH5251050001Medicare NSC
OH2499934Medicaid