Healthcare Provider Details

I. General information

NPI: 1881374031
Provider Name (Legal Business Name): EYE CO. MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W 5TH AVE
COLUMBUS OH
43212-2637
US

IV. Provider business mailing address

1001 W 5TH AVE
COLUMBUS OH
43212-2637
US

V. Phone/Fax

Practice location:
  • Phone: 234-643-9326
  • Fax: 614-705-6403
Mailing address:
  • Phone: 234-643-9326
  • Fax: 614-705-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code156FX1201X
TaxonomyOptometric Assistant Technician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: DR. NATALIE NGUYEN
Title or Position: OPTOMETRIST/OWNER
Credential: OD
Phone: 234-643-9326