Provider Demographics
NPI:1336259639
Name:VISUAL CARE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:VISUAL CARE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROZZO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-575-8020
Mailing Address - Street 1:6020 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-3355
Mailing Address - Country:US
Mailing Address - Phone:614-575-8020
Mailing Address - Fax:614-575-1716
Practice Address - Street 1:6020 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3355
Practice Address - Country:US
Practice Address - Phone:614-575-8020
Practice Address - Fax:614-575-1716
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VISUAL CARE ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3822152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5982008OtherAETNA
OH000000355175OtherANTHEM
OH294681769008OtherMEDICAL MUTUAL
OH5982008OtherAETNA
OH0779086Medicare PIN