Healthcare Provider Details
I. General information
NPI: 1609823384
Provider Name (Legal Business Name): NASS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2006
Last Update Date: 08/16/2020
Certification Date: 08/16/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6325 LEWIS DR STE 114
PARKVILLE MO
64152-3699
US
IV. Provider business mailing address
6325 LEWIS DR STE 114
PARKVILLE MO
64152-3699
US
V. Phone/Fax
- Phone: 816-505-0100
- Fax: 816-505-2301
- Phone: 816-505-0100
- Fax: 816-505-2301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANTHONY
JOSEPH
VERACHTERT
Title or Position: PRESIDENT
Credential: O.D.
Phone: 816-505-0100