Provider Demographics
NPI:1225655533
Name:VISION CARE CENTER LLC
Entity type:Organization
Organization Name:VISION CARE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:W
Authorized Official - Last Name:THARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-490-3937
Mailing Address - Street 1:PO BOX 3873
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47737-3873
Mailing Address - Country:US
Mailing Address - Phone:812-490-3937
Mailing Address - Fax:
Practice Address - Street 1:120 SE 4TH ST STE 1300
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47708-1607
Practice Address - Country:US
Practice Address - Phone:812-490-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty