Provider Demographics
NPI:1568810927
Name:CLEAR HORIZON EYECARE, LLC
Entity Type:Organization
Organization Name:CLEAR HORIZON EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:MCCLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-747-6443
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-0028
Mailing Address - Country:US
Mailing Address - Phone:860-747-6443
Mailing Address - Fax:860-747-8019
Practice Address - Street 1:112 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-1944
Practice Address - Country:US
Practice Address - Phone:860-747-6443
Practice Address - Fax:860-747-8019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004061420Medicaid
CT500000343Medicaid