<Unavail>

LBN: City Optical Co., Inc.
<Unavail> is an health care organization with primary practice located at 206 Concord Mall Dr , Elkhart IN 46517-3154. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. City Optical Co., Inc. can be contacted via phone (574) 875-4499, or through Tavel, Larry S via phone (317) 924-1300.

Contact Information

Primary practice address
206 Concord Mall Dr Elkhart IN 46517-3154
Phone: (574) 875-4499
Fax: (317) 924-3741
Website:
Map and Directions
Authorized official contact:
Name: Tavel, Larry S Doctor of Medicine (MD)
Phone: (317) 924-1300

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 18002299 Indiana
Eye and Vision Services Providers / Optometrist 152W00000X

Profile Details

NPI number 1891784971
LBN Legal business name City Optical Co., Inc.
DBA Doing business as <Unavail>
Authorized official Tavel, Larry S Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2005
Last updated Jul 22nd, 2026 - about 3 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891784971 NPPES
Indiana MEDICAID 200156010A

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