=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609924398
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY VISION CARE OF ALLIANCE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2007
-----------------------------------------------------
Last Update Date | 08/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1370 S SAWBURG AVE SUITE B
-----------------------------------------------------
City | ALLIANCE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44601-5761
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-821-5367
-----------------------------------------------------
Fax | 330-821-1981
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1370 S SAWBURG AVE SUITE B
-----------------------------------------------------
City | ALLIANCE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44601-5761
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-821-5367
-----------------------------------------------------
Fax | 330-821-1981
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RICK ROBENSTINE
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 330-821-5367
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 4975
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 3508
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------