Healthcare Provider Details

I. General information

NPI: 1871747592
Provider Name (Legal Business Name): BARRE OPTICIANS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2008
Last Update Date: 11/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 MAIN STREET SOUTH
SOUTH BARRE MA
01074
US

IV. Provider business mailing address

PO BOX 783 95 MAIN STREET SOUTH
SOUTH BARRE MA
01074
US

V. Phone/Fax

Practice location:
  • Phone: 978-355-2191
  • Fax: 978-355-2020
Mailing address:
  • Phone: 978-355-2191
  • Fax: 978-355-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number4043
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number4043
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number4043
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number4043
License Number StateMA
# 5
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number4043
License Number StateMA

VIII. Authorized Official

Name: MR. SALVATORE N IMPERATO
Title or Position: OWNER
Credential: REG. OPTICIAN/HEARIN
Phone: 978-355-2191