Provider Demographics
NPI:1497879944
Name:GIOVANETTI EYECARE, INC.
Entity Type:Organization
Organization Name:GIOVANETTI EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:GIOVANETTI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-574-2233
Mailing Address - Street 1:5537 BRIDGETOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-4329
Mailing Address - Country:US
Mailing Address - Phone:513-574-2233
Mailing Address - Fax:513-574-3937
Practice Address - Street 1:5537 BRIDGETOWN ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-4329
Practice Address - Country:US
Practice Address - Phone:513-574-2233
Practice Address - Fax:513-574-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3017069Medicaid
OH9281021OtherMEDICARE ID
OH=========OtherAETNA INS
OH=========OtherUNITED HEALTHCARE
OH3017069Medicaid
OH=========OtherHUMANA INS
OH9281021OtherMEDICARE ID
OH=========OtherHUMANA INS