Provider Demographics
NPI:1053057760
Name:EYECARE EXPRESS SCHERERVILLE INC
Entity type:Organization
Organization Name:EYECARE EXPRESS SCHERERVILLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-440-7121
Mailing Address - Street 1:116 INDIANAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-1204
Mailing Address - Country:US
Mailing Address - Phone:219-440-7121
Mailing Address - Fax:219-227-8480
Practice Address - Street 1:116 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1204
Practice Address - Country:US
Practice Address - Phone:219-440-7121
Practice Address - Fax:219-227-8480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty