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General NPI Number Information
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NPI Number | 1205951480
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Entity Type | Organization
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Legal Business Name | TOKARCZYK ENTERPRISES
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 621 3RD AVE
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City | INTERNATIONAL FALLS
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State | MN
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Zip | 56649-2637
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Country | US
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Telephone | 218-283-2015
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Fax | 218-283-5533
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Provider Business Mailing Address
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Address Line | 229 4TH ST
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City | SIOUX CITY
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State | IA
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Zip | 51101-1401
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Country | US
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Telephone | 712-252-1519
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Fax | 712-252-1916
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GEORGE TOKARCZYK
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Credential |
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Telephone | 712-252-1519
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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 | 2453963
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License Number State | MN
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