Provider Demographics
NPI:1659560183
Name:ADVANCED VISION CARE, INC
Entity Type:Organization
Organization Name:ADVANCED VISION CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHICK
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:419-991-3937
Mailing Address - Street 1:2300 BATON ROUGE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-1130
Mailing Address - Country:US
Mailing Address - Phone:419-991-3937
Mailing Address - Fax:419-991-3939
Practice Address - Street 1:2300 BATON ROUGE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-1130
Practice Address - Country:US
Practice Address - Phone:419-991-3937
Practice Address - Fax:419-991-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1284310001Medicare NSC