Provider Demographics
NPI:1215248620
Name:YORK EYE CARE ASSOCIATES LLC
Entity type:Organization
Organization Name:YORK EYE CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-393-6010
Mailing Address - Street 1:1684 VENTURE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-8950
Mailing Address - Country:US
Mailing Address - Phone:740-393-6010
Mailing Address - Fax:740-393-2320
Practice Address - Street 1:1684 VENTURE DR
Practice Address - Street 2:SUITE A
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-8950
Practice Address - Country:US
Practice Address - Phone:740-393-6010
Practice Address - Fax:740-393-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3446T730152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6194190001Medicare NSC