Healthcare Provider Details

I. General information

NPI: 1942859897
Provider Name (Legal Business Name): OCUCARE OPHTHALMIC SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 05/10/2023
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 WOODROW AVE
SAINT CLAIRSVILLE OH
43950-1187
US

IV. Provider business mailing address

156 WOODROW AVE STE 2B
SAINT CLAIRSVILLE OH
43950-1196
US

V. Phone/Fax

Practice location:
  • Phone: 740-695-2860
  • Fax: 740-695-1466
Mailing address:
  • Phone: 740-695-2680
  • Fax: 740-695-1466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EDWARD MCDONALD
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 740-695-2860