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General NPI Number Information
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NPI Number | 1023330156
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Entity Type | Organization
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Legal Business Name | BARGAIN OPTICAL, LLC
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 4176 N STATE ROAD 7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-4827
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Country | US
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Telephone | 954-607-8823
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Fax | 877-213-3600
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Provider Business Mailing Address
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Address Line | 4176 N STATE ROAD 7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-4827
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Country | US
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Telephone | 954-607-8823
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Fax | 877-213-3600
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. GABRIELLE LABOSSIERE
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Credential | LDO
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Telephone | 954-607-8823
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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 | DO5288
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License Number State | FL
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