Provider Demographics
NPI:1629343850
Name:GAINESVILLE-HAYMARKET EYECARE PLC
Entity Type:Organization
Organization Name:GAINESVILLE-HAYMARKET EYECARE PLC
Other - Org Name:GH EYE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOEGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:703-999-9279
Mailing Address - Street 1:7001 HERITAGE VILLAGE PLZ
Mailing Address - Street 2:110
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3065
Mailing Address - Country:US
Mailing Address - Phone:703-999-9279
Mailing Address - Fax:
Practice Address - Street 1:7001 HERITAGE VILLAGE PLZ
Practice Address - Street 2:110
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3065
Practice Address - Country:US
Practice Address - Phone:703-999-9279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000134152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty