Provider Demographics
NPI:1215278726
Name:FAMILY EYE CARE, LLC
Entity type:Organization
Organization Name:FAMILY EYE CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINBACH-WALLIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:302-764-5300
Mailing Address - Street 1:410 FOULK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3820
Mailing Address - Country:US
Mailing Address - Phone:302-764-5300
Mailing Address - Fax:302-764-4681
Practice Address - Street 1:410 FOULK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3820
Practice Address - Country:US
Practice Address - Phone:302-764-5300
Practice Address - Fax:302-764-4681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI30001135261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE123072Medicare UPIN