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General NPI Number Information
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NPI Number | 1013367085
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Entity Type | Organization
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Legal Business Name | PRIME OPTICALS LLC
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 2600 WILLOW STREET PIKE N
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City | WILLOW STREET
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State | PA
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Zip | 17584-9388
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Country | US
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Telephone | 412-491-7603
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Fax |
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Provider Business Mailing Address
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Address Line | 312 ECKER DR
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City | LITITZ
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State | PA
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Zip | 17543-6510
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAULIKKUMAR PATEL
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Credential |
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Telephone | 412-491-7603
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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 |
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License Number State |
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