Healthcare Provider Details

I. General information

NPI: 1558338624
Provider Name (Legal Business Name): UNION OPTICAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 LINCOLN WAY E
MASSILLON OH
44646-6833
US

IV. Provider business mailing address

915 LINCOLN WAY E
MASSILLON OH
44646-6833
US

V. Phone/Fax

Practice location:
  • Phone: 330-833-1091
  • Fax: 330-833-1092
Mailing address:
  • Phone: 330-833-1091
  • Fax: 330-833-1091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberSC-32
License Number StateOH

VIII. Authorized Official

Name: MR. MICHAEL EARL LOCKHART JR.
Title or Position: PRESIDENT
Credential: OD
Phone: 330-833-1091