Provider Demographics
NPI:1265970818
Name:EW 2020 LLC
Entity type:Organization
Organization Name:EW 2020 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-571-7177
Mailing Address - Street 1:83 N HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2601
Mailing Address - Country:US
Mailing Address - Phone:614-471-7177
Mailing Address - Fax:614-471-7225
Practice Address - Street 1:200 PUBLIC SQ
Practice Address - Street 2:SUITE 219
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2316
Practice Address - Country:US
Practice Address - Phone:216-621-2815
Practice Address - Fax:216-621-1745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty