Provider Demographics
NPI:1598904666
Name:RIVER CITY EYECARE, INC.
Entity type:Organization
Organization Name:RIVER CITY EYECARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:MCFEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-423-9521
Mailing Address - Street 1:1714 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-2096
Mailing Address - Country:US
Mailing Address - Phone:740-423-9521
Mailing Address - Fax:740-423-6882
Practice Address - Street 1:1714 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-2096
Practice Address - Country:US
Practice Address - Phone:740-423-9521
Practice Address - Fax:740-423-6882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5364670001OtherMEDICARE DURABLE MEDICAL EQUIPMENT
OH5250508Medicaid
OHRI9350881Medicare PIN
OHY27295Medicare UPIN
OH5364670001Medicare NSC