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General NPI Number Information
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NPI Number | 1164609236
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Entity Type | Organization
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Legal Business Name | DOUGLAS R. MANHIRE GUILD OPTICIANS
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 171 MOUNTAIN AVE
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-2418
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Country | US
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Telephone | 908-852-6623
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Fax | 908-852-2334
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Provider Business Mailing Address
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Address Line | 171 MOUNTAIN AVE
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-2418
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Country | US
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Telephone | 908-852-6623
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Fax | 908-852-2334
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Authorized Official
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Title or Position | OWNER
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Name | MR. DOUGLA R MANHIRE
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Credential | OPTICIAN
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Telephone | 908-852-6623
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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 | D775
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License Number State | NJ
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