Provider Demographics
NPI:1730147331
Name:DRS PRICE & SHEPLER FAMILY EYE CARE LLC
Entity type:Organization
Organization Name:DRS PRICE & SHEPLER FAMILY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:574-722-3937
Mailing Address - Street 1:444 MALL RD
Mailing Address - Street 2:P. O. BOX 24
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-2225
Mailing Address - Country:US
Mailing Address - Phone:574-722-3937
Mailing Address - Fax:574-735-3937
Practice Address - Street 1:444 MALL RD
Practice Address - Street 2:
Practice Address - City:LOGANSPORT
Practice Address - State:IN
Practice Address - Zip Code:46947-2225
Practice Address - Country:US
Practice Address - Phone:574-722-3937
Practice Address - Fax:574-735-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100071160AMedicaid
IN100071160AMedicaid
IN0576560001Medicare NSC