Provider Demographics
NPI:1780866590
Name:GREENE COUNTY EYE CARE, INC.
Entity Type:Organization
Organization Name:GREENE COUNTY EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:NICCOLE
Authorized Official - Last Name:FLORKEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-767-7991
Mailing Address - Street 1:1496 SOUTHGATE AVE
Mailing Address - Street 2:
Mailing Address - City:YELLOW SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:45387-1244
Mailing Address - Country:US
Mailing Address - Phone:937-767-7991
Mailing Address - Fax:937-767-3221
Practice Address - Street 1:1496 SOUTHGATE AVE
Practice Address - Street 2:
Practice Address - City:YELLOW SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:45387-1244
Practice Address - Country:US
Practice Address - Phone:937-767-7991
Practice Address - Fax:937-767-3221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5469332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
5966140003Medicare NSC
9367331Medicare PIN