Provider Demographics
NPI:1124235817
Name:FAMILY VISION CARE CENTERS LLC
Entity type:Organization
Organization Name:FAMILY VISION CARE CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:513-761-1616
Mailing Address - Street 1:3918 E GALBRAITH RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2322
Mailing Address - Country:US
Mailing Address - Phone:513-761-1616
Mailing Address - Fax:513-761-5523
Practice Address - Street 1:3918 E GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2322
Practice Address - Country:US
Practice Address - Phone:513-761-1616
Practice Address - Fax:513-761-5523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1538 SC332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0499938Medicaid
OH6138410001Medicare NSC