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General NPI Number Information
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NPI Number | 1568524734
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Entity Type | Organization
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Legal Business Name | EYEGLASS ACQUISITIONS, INC.
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 12/30/2008
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Provider Practice Location Address
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Address Line | 762 W MICHIGAN AVE
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City | JACKSON
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State | MI
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Zip | 49201-1978
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Country | US
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Telephone | 517-782-4409
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Fax | 517-782-4555
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Provider Business Mailing Address
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Address Line | PO BOX 2585
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City | PORTAGE
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State | MI
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Zip | 49081-2585
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Country | US
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Telephone | 269-373-8878
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Fax | 269-373-4720
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MS. THEA L TRAVIS
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Credential |
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Telephone | 269-372-0075
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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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