| |
20 S. Main Street, Ft. Loramie, OH 45845 | |
(937) 295-3307 | |
(937) 492-1901 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 20 S. Main Street, Ft. Loramie, Ohio |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528270311 | NPI | - | NPPES |
0461987 | Medicaid | OH | |
0304601 | Medicaid | OH | |
2454017 | Medicaid | OH | |
0669683 | Medicaid | OH | |
0991431 | Medicaid | OH | |
0266644 | Medicaid | OH | |
0762492 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Ohio) | Primary |
Mailing Address | Practice Location Address |
---|---|
1086 Fairington Drive, Sidney, OH 45365 Ph: (937) 492-9197 | 20 S. Main Street, Ft. Loramie, OH 45845 Ph: (937) 295-3307 |