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General NPI Number Information
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NPI Number | 1003146663
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Entity Type | Organization
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Legal Business Name | TOWN AND COUNTRY OPTICAL INC
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Dates
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Enumeration Date | 01/05/2010
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 535 BAY RD STE 2
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City | QUEENSBURY
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State | NY
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Zip | 12804-3019
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Country | US
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Telephone | 518-793-5395
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Fax | 518-793-5543
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Provider Business Mailing Address
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Address Line | 535 BAY RD STE 2
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City | QUEENSBURY
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State | NY
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Zip | 12804-3019
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Country | US
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Telephone | 518-793-5395
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Fax | 518-793-5543
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BARBARA J BRASSEL
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Credential |
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Telephone | 518-793-5395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0058491
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License Number State | NY
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