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General NPI Number Information
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NPI Number | 1447429287
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Entity Type | Organization
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Legal Business Name | KOSMOS NATIONAL OPTICAL, INC.
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 111 N WABASH AVE 1001
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 312-726-4090
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Fax | 312-726-9190
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Provider Business Mailing Address
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Address Line | 111 N WABASH AVE 1001
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 312-726-4090
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Fax | 312-726-9190
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL A. KOSMOS
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Credential | NCLC
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Telephone | 312-726-4090
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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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