Provider Demographics
NPI:1184962359
Name:EYECARE ON THE SQUARE LLC
Entity type:Organization
Organization Name:EYECARE ON THE SQUARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EHRYN
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:CARTWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-504-5104
Mailing Address - Street 1:6833 WOOSTER PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-4328
Mailing Address - Country:US
Mailing Address - Phone:513-504-5104
Mailing Address - Fax:
Practice Address - Street 1:6833 WOOSTER PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-4328
Practice Address - Country:US
Practice Address - Phone:513-504-5104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty