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General NPI Number Information
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NPI Number | 1194810754
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Entity Type | Organization
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Legal Business Name | LOWELL OPTICAL COMPANY
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11 CENTRAL STREET
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City | LOWELL
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State | MA
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Zip | 01852-1905
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Country | US
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Telephone | 978-458-4546
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Fax | 978-934-9264
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Provider Business Mailing Address
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Address Line | 11 CENTRAL STREET
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City | LOWELL
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State | MA
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Zip | 01852-1905
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Country | US
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Telephone | 978-458-4546
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Fax | 978-934-9264
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Authorized Official
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Title or Position | MANAGER
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Name | MS. MERNA VICTOR
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Credential |
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Telephone | 978-452-9302
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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 | 093020
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License Number State | MA
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