Provider Demographics
NPI:1427237494
Name:GREENE COUNTY EYE CARE, INC.
Entity type:Organization
Organization Name:GREENE COUNTY EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:NICCOLE
Authorized Official - Last Name:FLORKEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-766-2622
Mailing Address - Street 1:400 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CEDARVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45314-9508
Mailing Address - Country:US
Mailing Address - Phone:937-766-2622
Mailing Address - Fax:937-766-7120
Practice Address - Street 1:400 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDARVILLE
Practice Address - State:OH
Practice Address - Zip Code:45314-9508
Practice Address - Country:US
Practice Address - Phone:937-766-2622
Practice Address - Fax:937-766-7120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5469332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5966140001Medicare NSC
9367331Medicare PIN