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General NPI Number Information
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NPI Number | 1548474331
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Entity Type | Organization
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Legal Business Name | EYELINE OPTICAL EAST
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 310 HIGHWAY 51 NORTH SUITE B
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City | RIDGELAND
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State | MS
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Zip | 39157-3425
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Country | US
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Telephone | 601-607-7667
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Fax |
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Provider Business Mailing Address
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Address Line | 310 HIGHWAY 51 NORTH SUITE B
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City | RIDGELAND
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State | MS
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Zip | 39157-3425
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Country | US
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Telephone | 601-607-7667
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT GIURINTANO
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Credential |
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Telephone | 601-607-7667
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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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