Provider Demographics
NPI:1891717849
Name:FAMILY EYECARE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:FAMILY EYECARE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-674-6121
Mailing Address - Street 1:1275 GLEN DR
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-8958
Mailing Address - Country:US
Mailing Address - Phone:330-674-6121
Mailing Address - Fax:330-674-7409
Practice Address - Street 1:1275 GLEN DR
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-8958
Practice Address - Country:US
Practice Address - Phone:330-674-6121
Practice Address - Fax:330-674-7409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0468088Medicaid
OH0468079Medicaid
OH0130478Medicaid
OH0468079Medicaid
OH0468088Medicaid
OH9272861Medicare PIN
OH0468079Medicaid