Healthcare Provider Details
I. General information
NPI: 1437593126
Provider Name (Legal Business Name): USV OPTICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2013
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4141 MORRISH RD.
SWARTZ CREEK MI
48473
US
IV. Provider business mailing address
1 HARMON DR
BLACKWOOD NJ
08012-5103
US
V. Phone/Fax
- Phone: 810-630-0399
- Fax:
- Phone: 856-228-1000
- Fax: 856-718-3572
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RANDI
WOERNER
Title or Position: PROFESSIONAL RELATIONS MANAGER
Credential:
Phone: 856-228-1000