MEDICARE: MIDWEST EYE CONSULTANTS OHIO, 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

General Provider Information

NPI Number	:	1376275131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST EYE CONSULTANTS OHIO, INC

Provider Business Mailing Address
First Line	:	PO BOX 432
Second Line	:
City	:	WABASH
State	:	IN
Zip	:	46992-0432
Country	:	US
Telephone Number	:	260-569-9550
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 SPRINGSIDE DR STE 300C
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333-4526
Country	:	US
Telephone Number	:	330-666-0707
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	CATHY GARRETT
Credential	:
Telephone Number	:	260-569-9550

Provider Enumeration Date	:	06/29/2022
Last Update Date	:	05/24/2024

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