Provider Demographics
NPI:1356523484
Name:MORROW VISION CENTER, INC.
Entity type:Organization
Organization Name:MORROW VISION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-946-6881
Mailing Address - Street 1:91 E MARION ST
Mailing Address - Street 2:
Mailing Address - City:MT, GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-1480
Mailing Address - Country:US
Mailing Address - Phone:419-946-6881
Mailing Address - Fax:
Practice Address - Street 1:91 E MARION ST
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-1434
Practice Address - Country:US
Practice Address - Phone:419-946-6881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3280T365311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0675023Medicaid
U22158Medicare UPIN
OH0675023Medicaid