Healthcare Provider Details

I. General information

NPI: 1619790185
Provider Name (Legal Business Name): MIDWEST EYE CONSULTANTS OHIO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2694 S. MAIN ST
AKRON OH
44319
US

IV. Provider business mailing address

PO BOX 432
WABASH IN
46992-0432
US

V. Phone/Fax

Practice location:
  • Phone: 330-785-5111
  • Fax:
Mailing address:
  • Phone: 260-569-9550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: CATHY GARRETT
Title or Position: COO
Credential:
Phone: 260-569-9550