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General NPI Number Information
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NPI Number | 1285979666
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Entity Type | Organization
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Legal Business Name | OPTICAL CENTER, INC.
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 17747 CHILLICOTHE RD
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City | CHAGRIN FALLS
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State | OH
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Zip | 44023-4739
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Country | US
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Telephone | 440-543-1044
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Fax |
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Provider Business Mailing Address
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Address Line | 17747 CHILLICOTHE RD
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City | CHAGRIN FALLS
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State | OH
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Zip | 44023-4739
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Country | US
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Telephone | 440-543-1044
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PATRICK J OBRIEN
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Credential |
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Telephone | 440-543-1044
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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 | 1340S
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License Number State | OH
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