Provider Demographics
NPI:1710155031
Name:HARRIS EYE CARE
Entity Type:Organization
Organization Name:HARRIS EYE CARE
Other - Org Name:DANIEL C. HARRIS, O.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-791-2283
Mailing Address - Street 1:300 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-7865
Mailing Address - Country:US
Mailing Address - Phone:937-681-4956
Mailing Address - Fax:513-791-2938
Practice Address - Street 1:300 COUNTRYSIDE DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-7865
Practice Address - Country:US
Practice Address - Phone:937-681-4956
Practice Address - Fax:513-791-2938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4286261Q00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0896679Medicaid
OHU29955Medicare UPIN
OH0896679Medicaid
OH0712882Medicare PIN