Healthcare Provider Details

I. General information

NPI: 1356580245
Provider Name (Legal Business Name): THE VISION CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 CHESTNUT ST
EVANSVILLE IN
47713-1227
US

IV. Provider business mailing address

PO BOX 3873
EVANSVILLE IN
47737-3873
US

V. Phone/Fax

Practice location:
  • Phone: 812-490-3937
  • Fax: 812-426-9880
Mailing address:
  • Phone: 800-467-2392
  • Fax: 812-471-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW W THARP
Title or Position: PRESIDENT
Credential: MD
Phone: 812-490-3937