Provider Demographics
NPI:1689350407
Name:ICARE VISION LLC
Entity Type:Organization
Organization Name:ICARE VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-898-2884
Mailing Address - Street 1:3 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870-1845
Mailing Address - Country:US
Mailing Address - Phone:570-898-2884
Mailing Address - Fax:
Practice Address - Street 1:567 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5316
Practice Address - Country:US
Practice Address - Phone:570-898-2884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty