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General NPI Number Information
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NPI Number | 1295133130
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Entity Type | Organization
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Legal Business Name | EYEMART EXPRESS LLC
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 213 COX CREEK PKWY
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City | FLORENCE
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State | AL
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Zip | 35630-1572
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Country | US
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Telephone | 256-766-8075
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Fax | 256-718-8587
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Provider Business Mailing Address
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Address Line | 213 COX CREEK PKWY
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City | FLORENCE
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State | AL
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Zip | 35630-1572
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Country | US
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Telephone | 256-766-8075
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Fax | 256-718-8587
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Authorized Official
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Title or Position | DIRECTOR OF MANAGED CARE
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Name | KAREN PITTMAN
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Credential |
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Telephone | 972-488-2002
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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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