is a Eyewear Supplier in , . practices all healthcare services and medical treatments related to Eyewear Supplier. The NPI Number for is 1124070644. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1124070644 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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| Phone Number | |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Eyewear Supplier |
|---|---|
| Taxonomy | 332H00000X |
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Definition: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 41098505420 | NE | -- | |
| CP2230-30 | EYEMED | ||
| 17890 | MEDICARE | ||
| 14056 | VIP | ||
| 35503 | AVESIS | ||
| 35866 | DAVIS | ||
| 9774 | BLOCK | ||
| 92603 | MEDICARE |
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