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General NPI Number Information
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NPI Number | 1023495546
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Entity Type | Organization
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Legal Business Name | STANICH EYE CARE, INC
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 796 HOWE AVE
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44221-5124
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Country | US
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Telephone | 330-928-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 660 RED ROCK DR
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City | WADSWORTH
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State | OH
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Zip | 44281-2284
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHARON CHIRUMBOLE
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Credential |
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Telephone | 330-606-7890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4493
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License Number State | OH
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