Provider Demographics
NPI:1710705371
Name:GROVE CITY EYE SURGERY CENTER
Entity type:Organization
Organization Name:GROVE CITY EYE SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIESMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-774-4434
Mailing Address - Street 1:50 N PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1757
Mailing Address - Country:US
Mailing Address - Phone:740-774-4434
Mailing Address - Fax:
Practice Address - Street 1:3154 PARK ST
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-3222
Practice Address - Country:US
Practice Address - Phone:614-801-9111
Practice Address - Fax:614-801-1643
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE SPECIALIST INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical