Provider Demographics
NPI:1730268004
Name:EYE CARE ASSOCIATES OF BEVERLY LLC
Entity type:Organization
Organization Name:EYE CARE ASSOCIATES OF BEVERLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LYNDSAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-373-2069
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45715-0145
Mailing Address - Country:US
Mailing Address - Phone:740-984-4218
Mailing Address - Fax:740-984-4885
Practice Address - Street 1:505 5TH STREET SUITE C
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:OH
Practice Address - Zip Code:45715
Practice Address - Country:US
Practice Address - Phone:740-984-4218
Practice Address - Fax:740-984-4885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2043532Medicaid
311288227003OtherMEDICAL MUTUAL
410015409OtherRAILROAD MEDICARE
OH0445820001Medicare NSC
311288227003OtherMEDICAL MUTUAL
OH9295891Medicare PIN
T47719Medicare UPIN