Beach Vision LLC
Organization Active NPI Optometrist · Greenville, OH
NPI 1740975358 · NPPES record last updated Apr 10, 2023
Key facts
- NPI
- 1740975358
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- BEACH VISION LLC
- Practice address
- 1501 Wagner Ave
Greenville, OH 45331-2763 - Phone
- (937) 547-9012
- Fax
- (937) 547-9361
- NPI assigned
- Apr 10, 2023
- Organization subpart
- No
Authorized official
- Name
- Mark A Beach, OD
- Title
- Owner/Optometrist
- Phone
- (937) 547-9012
Practitioners 1
-
Mark Adam Beach, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240805001457 | OH | Part B Supplier - Clinic/Group Practice | 1557808847 |
Receives reassigned benefits from 1 practitioner Practice locations: Greenville, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
1501 Wagner Ave
Greenville, OH 45331-2763
Mailing address
1501 Wagner Ave
Greenville, OH 45331-2763
Phone (937) 547-9012
Other providers in Greenville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.