Provider Demographics
NPI:1265513956
Name:CARAFICE AND HALLQUIST, INC.
Entity type:Organization
Organization Name:CARAFICE AND HALLQUIST, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDIJO
Authorized Official - Middle Name:M
Authorized Official - Last Name:HALLQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-520-9542
Mailing Address - Street 1:3116 W. MONTGOMERY RD.
Mailing Address - Street 2:SUITE C #275
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8609
Mailing Address - Country:US
Mailing Address - Phone:513-228-0790
Mailing Address - Fax:513-228-0790
Practice Address - Street 1:8775 S. MASON-MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7675
Practice Address - Country:US
Practice Address - Phone:513-770-4178
Practice Address - Fax:513-770-4187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4256-T1271152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2217050Medicaid
OH0984716Medicaid
OHU33661Medicare UPIN
OH0984716Medicaid