Provider Demographics
NPI:1659573962
Name:JAMES GROVE & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:JAMES GROVE & ASSOCIATES, LLC
Other - Org Name:ASSOCIATES IN OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-653-5228
Mailing Address - Street 1:303 N MAIN ST
Mailing Address - Street 2:P,O, BOX 70
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-1605
Mailing Address - Country:US
Mailing Address - Phone:937-653-5228
Mailing Address - Fax:937-653-5158
Practice Address - Street 1:303 N MAIN ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-1605
Practice Address - Country:US
Practice Address - Phone:937-653-5228
Practice Address - Fax:937-653-5158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5180152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHJA9370031OtherMEDICARE GROUP NUMBER
OH2767528Medicaid
6062670001Medicare NSC
OHJA9370031OtherMEDICARE GROUP NUMBER