Provider Demographics
NPI:1568581965
Name:OHIO EYE CARE CONSULTANTS, LLC
Entity Type:Organization
Organization Name:OHIO EYE CARE CONSULTANTS, LLC
Other - Org Name:NORTHEAST OHIO EYE SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PERRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-722-8300
Mailing Address - Street 1:3583 RESERVE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8180
Mailing Address - Country:US
Mailing Address - Phone:330-722-8300
Mailing Address - Fax:330-725-0445
Practice Address - Street 1:3583 RESERVE COMMONS DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8180
Practice Address - Country:US
Practice Address - Phone:330-722-8300
Practice Address - Fax:330-725-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000292120OtherANTHEM
OH2666164Medicaid
OH5747830001Medicare NSC
000000292120OtherANTHEM