Provider Demographics
NPI:1689886418
Name:WINCHESTER VISION CARE INC
Entity type:Organization
Organization Name:WINCHESTER VISION CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-837-9595
Mailing Address - Street 1:6472 WINCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-2004
Mailing Address - Country:US
Mailing Address - Phone:614-837-9595
Mailing Address - Fax:614-837-8205
Practice Address - Street 1:6472 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-2004
Practice Address - Country:US
Practice Address - Phone:614-837-9595
Practice Address - Fax:614-837-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0580929Medicaid
OH2492404Medicaid
T48201Medicare UPIN
MY0566444Medicare PIN
KE4162222Medicare PIN
OH0580929Medicaid
OH5648480001Medicare NSC