Provider Demographics
NPI:1821490178
Name:ADVANCED FOCUS CARE LLC
Entity Type:Organization
Organization Name:ADVANCED FOCUS CARE LLC
Other - Org Name:FOCUS EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:OLUND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-944-9944
Mailing Address - Street 1:5120 CHARLESTOWN RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-9497
Mailing Address - Country:US
Mailing Address - Phone:812-944-9944
Mailing Address - Fax:812-284-2326
Practice Address - Street 1:5120 CHARLESTOWN RD
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-9497
Practice Address - Country:US
Practice Address - Phone:812-944-9944
Practice Address - Fax:812-284-2326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003755152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201081460Medicaid
IN201081460Medicaid