Provider Demographics
NPI:1790414845
Name:EVANS FARM FAMILY EYE CARE, LLC
Entity Type:Organization
Organization Name:EVANS FARM FAMILY EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:KREBS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-773-9555
Mailing Address - Street 1:5875 EVANS FARM DR.
Mailing Address - Street 2:SUITE K
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035
Mailing Address - Country:US
Mailing Address - Phone:614-524-4393
Mailing Address - Fax:614-704-5393
Practice Address - Street 1:5875 EVANS FARM DR.
Practice Address - Street 2:SUITE K
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035
Practice Address - Country:US
Practice Address - Phone:614-524-4393
Practice Address - Fax:614-704-5393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty