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General NPI Number Information
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NPI Number | 1144394248
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Entity Type | Organization
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Legal Business Name | LANG OPTICAL INC.
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 280 S LOGAN ST
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City | ELYRIA
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State | OH
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Zip | 44035-6224
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Country | US
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Telephone | 440-365-9311
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Fax | 440-366-5057
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Provider Business Mailing Address
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Address Line | 280 S LOGAN ST
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City | ELYRIA
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State | OH
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Zip | 44035-6224
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Country | US
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Telephone | 440-365-9311
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Fax | 440-366-5057
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. KIMBERLY ANN GURD
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Credential | LICENSED OPTICIAN
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Telephone | 440-365-9311
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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 | 0249170001
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License Number State | OH
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