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General NPI Number Information
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NPI Number | 1417137936
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Entity Type | Organization
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Legal Business Name | OPTICAL MANAGEMENT SERVICES, LLC
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 2185 18 MILE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314
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Country | US
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Telephone | 248-879-2388
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Fax | 248-879-3378
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Provider Business Mailing Address
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Address Line | 2185 18 MILE ROAD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314
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Country | US
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Telephone | 248-879-2388
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Fax | 248-879-3378
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | RENEE MARIE HERRINGTON
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Credential |
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Telephone | 989-798-6020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002762
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License Number State | MI
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