Provider Demographics
NPI:1609992502
Name:IN VISION EYE CARE, INC.
Entity Type:Organization
Organization Name:IN VISION EYE CARE, INC.
Other - Org Name:EYEWORKS VISION CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:D
Authorized Official - Last Name:AMMON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:302-235-7031
Mailing Address - Street 1:210 LANTANA DR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8805
Mailing Address - Country:US
Mailing Address - Phone:302-235-7031
Mailing Address - Fax:302-235-7032
Practice Address - Street 1:210 LANTANA DR
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8805
Practice Address - Country:US
Practice Address - Phone:302-235-7031
Practice Address - Fax:302-235-7032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI3-0001250152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEU80320Medicare UPIN
DE490594Medicare ID - Type Unspecified