Provider Demographics
NPI:1932239969
Name:OPTICAL DISPENSING COMPANY, P.C.
Entity Type:Organization
Organization Name:OPTICAL DISPENSING COMPANY, P.C.
Other - Org Name:DOWNTOWN EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-634-9909
Mailing Address - Street 1:50 SOUTH MERIDIAN STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204
Mailing Address - Country:US
Mailing Address - Phone:317-634-9909
Mailing Address - Fax:925-889-2485
Practice Address - Street 1:50 SOUTH MERIDIAN STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204
Practice Address - Country:US
Practice Address - Phone:317-634-9909
Practice Address - Fax:925-889-2485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001977A152W00000X, 152WC0802X
IN152W00000X
IN18001977B152W00000X
IN18001795B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1237170001OtherMEDICARE DME MAC
INU26417Medicare UPIN
IN1237170001Medicare NSC
IN248170BMedicare PIN
IN248170AMedicare PIN
INU24188Medicare UPIN
IN248170Medicare PIN