Healthcare Provider Details

I. General information

NPI: 1366463002
Provider Name (Legal Business Name): OPTICAL MANAGEMENT SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G4325 MILLER ROAD
FLINT MI
48507-1216
US

IV. Provider business mailing address

2222 N BEECH DALY RD SUITE A-1
DEARBORN HEIGHTS MI
48127-3491
US

V. Phone/Fax

Practice location:
  • Phone: 810-230-9292
  • Fax: 810-230-7841
Mailing address:
  • Phone: 313-563-5121
  • Fax: 313-563-5179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901002165
License Number StateMI

VIII. Authorized Official

Name: DR. MILTON ARNOLD MEYERS
Title or Position: PRESIDENT
Credential: O.D.
Phone: 313-563-5121