MEDICARE: CRAWFORD COUNTY FAMILY EYE CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174798607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAWFORD COUNTY FAMILY EYE CARE INC

Provider Business Mailing Address
First Line	:	337 HARDING WAY W
Second Line	:
City	:	GALION
State	:	OH
Zip	:	44833-1725
Country	:	US
Telephone Number	:	419-468-3355
Fax Number	:	419-468-7475

Provider Business Practice Location Address
First Line	:	337 HARDING WAY W
Second Line	:
City	:	GALION
State	:	OH
Zip	:	44833-1725
Country	:	US
Telephone Number	:	419-468-3355
Fax Number	:	419-468-7475

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RANDALL HIEBER
Credential	:	O.D.
Telephone Number	:	419-468-3355

Provider Enumeration Date	:	04/25/2008
Last Update Date	:	11/29/2011

Similar Medicare Providers

1114922218 — DR. RANDALL R HIEBER O.D.
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1972509586 — DR. CHRISTINA HICKLE WALKER O.D.
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1174217673 — RAVEN MARIE VANHOUTEN LSW
Practice Location Address:

7807 STATE ROUTE 309 LOT 1
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