Provider Demographics
NPI:1922331131
Name:INDIANA EYECARE CENTER PC
Entity Type:Organization
Organization Name:INDIANA EYECARE CENTER PC
Other - Org Name:INDIANA EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRISCHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-915-3937
Mailing Address - Street 1:7440 N SHADELAND AVE
Mailing Address - Street 2:SUITE #160
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2029
Mailing Address - Country:US
Mailing Address - Phone:317-915-3937
Mailing Address - Fax:317-915-3946
Practice Address - Street 1:7440 N SHADELAND AVE
Practice Address - Street 2:SUITE #160
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2029
Practice Address - Country:US
Practice Address - Phone:317-915-3937
Practice Address - Fax:317-915-3946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN259440Medicare PIN
IN6247960001Medicare NSC