Healthcare Provider Details

I. General information

NPI: 1841609468
Provider Name (Legal Business Name): EMERGING VISION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 S BROADWAY
MINOT ND
58701-7331
US

IV. Provider business mailing address

3220 S BROADWAY
MINOT ND
58701-7331
US

V. Phone/Fax

Practice location:
  • Phone: 701-852-5200
  • Fax: 701-837-0474
Mailing address:
  • Phone: 701-852-5200
  • Fax: 701-837-0474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: FRANCINE M SUAREZ
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 212-729-5331