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General NPI Number Information
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NPI Number | 1609214477
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Entity Type | Organization
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Legal Business Name | USV OPTICAL INC.
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 4901 STATE ROAD 26 E
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City | LAFAYETTE
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State | IN
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Zip | 47905-4611
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Country | US
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Telephone | 765-446-2534
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Fax | 765-446-2587
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Provider Business Mailing Address
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Address Line | 1 HARMON DR
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City | BLACKWOOD
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State | NJ
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Zip | 08012-5103
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Country | US
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Telephone | 856-228-1000
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Fax | 856-718-3572
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Authorized Official
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Title or Position | PROFESSIONAL RELATIONS MANAGER
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Name | RANDI WOERNER
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Credential |
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Telephone | 856-228-1000
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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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