Provider Demographics
NPI:1275610099
Name:EYE CARE ASSOCIATES OF BELPRE
Entity type:Organization
Organization Name:EYE CARE ASSOCIATES OF BELPRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:STANWICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-423-6533
Mailing Address - Street 1:2201 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1989
Mailing Address - Country:US
Mailing Address - Phone:740-423-6533
Mailing Address - Fax:740-423-8367
Practice Address - Street 1:2201 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1989
Practice Address - Country:US
Practice Address - Phone:740-423-6533
Practice Address - Fax:740-423-8367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0183751Medicaid
OH410025339OtherRAILROAD MEDICARE
OH0854295Medicaid
OHDH0990OtherRAILROAD GROUP
OH410025339OtherRAILROAD MEDICARE
OH1215470001Medicare NSC
V06057Medicare UPIN
U19160Medicare UPIN
OH9231511Medicare PIN