Provider Demographics
NPI:1679694152
Name:FINDLAY OPTOMETRY CLINIC INC
Entity type:Organization
Organization Name:FINDLAY OPTOMETRY CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:W
Authorized Official - Last Name:SKULINA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-422-3472
Mailing Address - Street 1:123 W SANDUSKY ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3215
Mailing Address - Country:US
Mailing Address - Phone:419-422-3472
Mailing Address - Fax:419-422-3786
Practice Address - Street 1:123 W SANDUSKY ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3215
Practice Address - Country:US
Practice Address - Phone:419-422-3472
Practice Address - Fax:419-422-3786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4314T655152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0381439Medicaid
OH0341740001Medicare NSC
OH0381439Medicaid