Provider Demographics
NPI:1801173133
Name:OPTIVIEW VISION & HEARING CENTER
Entity type:Organization
Organization Name:OPTIVIEW VISION & HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PERSHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-644-0506
Mailing Address - Street 1:4648 S SCATTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-2900
Mailing Address - Country:US
Mailing Address - Phone:765-644-0506
Mailing Address - Fax:765-622-0958
Practice Address - Street 1:4648 S SCATTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-2900
Practice Address - Country:US
Practice Address - Phone:765-644-0506
Practice Address - Fax:765-622-0958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002500A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty