Provider Demographics
NPI:1710168646
Name:TIMOTHY A. ANDREWS CO OD
Entity Type:Organization
Organization Name:TIMOTHY A. ANDREWS CO OD
Other - Org Name:ANDREWS EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-527-3937
Mailing Address - Street 1:1 MEMORY LN STE 100
Mailing Address - Street 2:
Mailing Address - City:GARRETTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44231-9443
Mailing Address - Country:US
Mailing Address - Phone:330-527-3937
Mailing Address - Fax:330-527-3939
Practice Address - Street 1:1 MEMORY LN STE 100
Practice Address - Street 2:
Practice Address - City:GARRETTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44231-9443
Practice Address - Country:US
Practice Address - Phone:330-527-3937
Practice Address - Fax:330-527-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9299051Medicare PIN
OH0715250001Medicare NSC