is a Eyewear Supplier in , . practices all healthcare services and medical treatments related to Eyewear Supplier. The NPI Number for is 1649222878. 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 | 1649222878 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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| Phone Number | |
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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 |
|---|---|---|---|
| 35504 | AVESIS | ||
| 17884 | MEDICARE | ||
| 260474 | MEDICARE | ||
| 41098505418 | NE | -- | |
| 7124 | BLOCK | ||
| 14044 | VIP | ||
| 35860 | DAVIS | ||
| CP2230-31 | EYEMED |
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