Provider Demographics
NPI:1720155534
Name:ASSOCIATED EYE CARE INC
Entity Type:Organization
Organization Name:ASSOCIATED EYE CARE INC
Other - Org Name:OPTICAL ILLUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FALZONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-882-0588
Mailing Address - Street 1:1000 REGENCY CT
Mailing Address - Street 2:STE 100
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3074
Mailing Address - Country:US
Mailing Address - Phone:419-882-0588
Mailing Address - Fax:419-885-3070
Practice Address - Street 1:1000 REGENCY CT
Practice Address - Street 2:STE 100
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3074
Practice Address - Country:US
Practice Address - Phone:419-882-0588
Practice Address - Fax:419-885-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCI3304OtherRAILROAD MEDCIARE
OH000000163747OtherANTHEM
OH2057821Medicaid
OH000000163747OtherANTHEM
OH2516620001Medicare NSC