Provider Demographics
NPI:1659465862
Name:UNION EYES OPTICAL, INC
Entity Type:Organization
Organization Name:UNION EYES OPTICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:REMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-759-7846
Mailing Address - Street 1:229 CHURCHILL-HUBBARD RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505
Mailing Address - Country:US
Mailing Address - Phone:330-759-7846
Mailing Address - Fax:330-759-0469
Practice Address - Street 1:229 CHURCHILL-HUBBARD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505
Practice Address - Country:US
Practice Address - Phone:330-759-7846
Practice Address - Fax:330-759-0469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS5193156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2572916Medicaid
OH2572916Medicaid