Provider Demographics
NPI:1508005877
Name:OPTOMETRIC SERVICES, LLC
Entity Type:Organization
Organization Name:OPTOMETRIC SERVICES, LLC
Other - Org Name:HARMONY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VERBECK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-423-4984
Mailing Address - Street 1:111 S RED BANK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-6526
Mailing Address - Country:US
Mailing Address - Phone:812-423-4984
Mailing Address - Fax:
Practice Address - Street 1:111 S RED BANK RD STE A
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-6509
Practice Address - Country:US
Practice Address - Phone:812-423-4984
Practice Address - Fax:812-423-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003218152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6222040001Medicare NSC
INDQ1071Medicare PIN
ILIL8307Medicare PIN
IN259940Medicare PIN