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General NPI Number Information
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NPI Number | 1003144734
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Entity Type | Organization
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Legal Business Name | QUALITY EYEWEAR LLC
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Dates
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Enumeration Date | 11/18/2009
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Last Update Date | 11/18/2009
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Provider Practice Location Address
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Address Line | 832 PRINCETON AVE SW
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City | BIRMINGHAM
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State | AL
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Zip | 35211-1320
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Country | US
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Telephone | 205-397-2287
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Fax | 205-397-0985
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Provider Business Mailing Address
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Address Line | 832 PRINCETON AVE SW
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City | BIRMINGHAM
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State | AL
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Zip | 35211-1320
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Country | US
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Telephone | 205-397-2287
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Fax | 205-397-0985
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERALD SIMON
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Credential | OD
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Telephone | 205-397-2287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 09010865
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License Number State | AL
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