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General NPI Number Information
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NPI Number | 1164814430
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Entity Type | Organization
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Legal Business Name | EMPIRE VISION CENTER, INC.
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Dates
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Enumeration Date | 02/24/2015
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 70 WORCESTER PROVIDENCE TPKE SUITE 507
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City | MILLBURY
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State | MA
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Zip | 01527-2663
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Country | US
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Telephone | 508-865-5196
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Fax | 508-865-2076
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Provider Business Mailing Address
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Address Line | PO BOX 418348
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City | BOSTON
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State | MA
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Zip | 02241-8348
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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 | DIRECTOR
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Name | DOROTHY REYNOLDS
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Credential |
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Telephone | 210-524-6663
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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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