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General NPI Number Information
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NPI Number | 1154556298
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Entity Type | Organization
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Legal Business Name | EYEMART EXPRESS, LTD
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 745 E JOYCE BLVD SUITE 124
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-6375
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Country | US
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Telephone | 479-528-1366
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Fax | 479-581-1398
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Provider Business Mailing Address
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Address Line | 745 E JOYCE BLVD SUITE 124
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-6375
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Country | US
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Telephone | 479-528-1366
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Fax | 479-581-1398
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JONATHAN HERSKOVITZ
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Credential |
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Telephone | 972-488-2002
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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 |
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License Number State |
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