Provider Demographics
NPI:1932308772
Name:EYECARE EXPRESS-TERRE HAUTE INC.
Entity Type:Organization
Organization Name:EYECARE EXPRESS-TERRE HAUTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SCHRAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-271-7228
Mailing Address - Street 1:15820 PRESWICK LN
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-9067
Mailing Address - Country:US
Mailing Address - Phone:574-271-7228
Mailing Address - Fax:
Practice Address - Street 1:3347 S. U.S. HWY 41
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802
Practice Address - Country:US
Practice Address - Phone:574-271-7228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty