| |
6050 State Route 571, Greenville, OH 45331-9695 | |
(937) 548-8229 | |
(937) 548-1911 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 6050 State Route 571, Greenville, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396726667 | NPI | - | NPPES |
2140418 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 457, Richmond, IN 47375-0457 Ph: (765) 966-1945 | 6050 State Route 571, Greenville, OH 45331-9695 Ph: (937) 548-8229 |