Provider Demographics
NPI:1295056364
Name:ONYI EYE SERVICES, LLC
Entity type:Organization
Organization Name:ONYI EYE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ONYINYECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ACHIONYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-526-7782
Mailing Address - Street 1:8225 MALL PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6994
Mailing Address - Country:US
Mailing Address - Phone:678-526-7782
Mailing Address - Fax:678-710-9907
Practice Address - Street 1:8225 MALL PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6994
Practice Address - Country:US
Practice Address - Phone:678-526-7782
Practice Address - Fax:678-710-9907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT 002224152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA407665514OMedicaid
GA202G703951Medicare PIN