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NPI Code Detail

MEDICARE: ABOITE FAMILY EYECARE CENTER, INC.

MEDICARE: ABOITE FAMILY EYECARE CENTER, 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
1305R00000XPreferred Provider Organization351655933IN
2152W00000XOptometrist

General Provider Information

NPI Number : 1932502507
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABOITE FAMILY EYECARE CENTER, INC.
Provider Business Mailing Address
First Line : 7625 WEST JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4133
Country : US
Telephone Number : 260-432-1231
Fax Number : 260-969-1568
Provider Business Practice Location Address
First Line : 7625 WEST JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4133
Country : US
Telephone Number : 260-432-1231
Fax Number : 260-969-1568
Authorized Official
Title or Position : OWNER
Name : THOMAS ZACHMAN
Credential : O.D
Telephone Number : 260-432-1231
Provider Enumeration Date : 09/26/2014
Last Update Date : 04/20/2022

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