Healthcare Provider Details

I. General information

NPI: 1346285624
Provider Name (Legal Business Name): NORTHWEST OHIO EYECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 W CENTRAL AVE STE C
TOLEDO OH
43615-1513
US

IV. Provider business mailing address

5550 W CENTRAL AVE STE C
TOLEDO OH
43615-1513
US

V. Phone/Fax

Practice location:
  • Phone: 419-539-6989
  • Fax: 419-539-6988
Mailing address:
  • Phone: 419-539-6989
  • Fax: 419-539-6988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DONNA MARIE MAHAFFEY
Title or Position: OWNER
Credential: OD
Phone: 419-539-6989