MEDICARE: OPTIC HEALTH CARE

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1790559789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIC HEALTH CARE

Provider Business Mailing Address
First Line	:	5300 E MAIN ST STE 204A
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2580
Country	:	US
Telephone Number	:	614-285-6341
Fax Number	:	614-288-2132

Provider Business Practice Location Address
First Line	:	5300 E MAIN ST STE 204A
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2580
Country	:	US
Telephone Number	:	614-285-6341
Fax Number	:	614-288-2132

Authorized Official
Title or Position	:	OWNER
Name	:	LINDA TEBONG
Credential	:
Telephone Number	:	513-394-1889

Provider Enumeration Date	:	11/09/2023
Last Update Date	:	11/09/2023

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Directions to “OPTIC HEALTH CARE ” Practice Location

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