Healthcare Provider Details

I. General information

NPI: 1336612514
Provider Name (Legal Business Name): EYES ON COLUMBUS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 BETHEL RD
COLUMBUS OH
43220-2217
US

IV. Provider business mailing address

3 S SPRING RD
WESTERVILLE OH
43081-2444
US

V. Phone/Fax

Practice location:
  • Phone: 614-326-0761
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. EVANGELIA FRAGOULIS
Title or Position: PRESIDENT
Credential: OD
Phone: 614-596-6657