Provider Demographics
NPI:1841469376
Name:HERITAGE FAMILY EYE CARE, INC
Entity type:Organization
Organization Name:HERITAGE FAMILY EYE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:GEBHART
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-850-6151
Mailing Address - Street 1:5123 NORWICH ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1486
Mailing Address - Country:US
Mailing Address - Phone:614-850-6151
Mailing Address - Fax:614-850-7052
Practice Address - Street 1:5123 NORWICH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1486
Practice Address - Country:US
Practice Address - Phone:614-850-6151
Practice Address - Fax:614-850-7052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5626152WP0200X
OH5018152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHE9319841Medicare PIN