Healthcare Provider Details

I. General information

NPI: 1326290495
Provider Name (Legal Business Name): OPTIQUE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3233 BELMONT ST
BELLAIRE OH
43906-1520
US

IV. Provider business mailing address

3233 BELMONT ST
BELLAIRE OH
43906-1520
US

V. Phone/Fax

Practice location:
  • Phone: 740-676-4717
  • Fax: 740-676-4695
Mailing address:
  • Phone: 740-676-4717
  • Fax: 740-676-4695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number3515
License Number StateOH

VIII. Authorized Official

Name: DR. DAVID M. MELGARY
Title or Position: PRESIDENT
Credential: O.D.
Phone: 740-676-4717