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General NPI Number Information
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NPI Number | 1699035972
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Entity Type | Organization
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Legal Business Name | BARTON PERREIRA RETAIL II, LLC
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 4017 HILLSBORO PIKE 309-A
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City | NASHVILLE
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State | TN
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Zip | 37215-2777
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Country | US
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Telephone | 615-891-4807
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Fax | 615-915-3124
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Provider Business Mailing Address
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Address Line | 4017 HILLSBORO PIKE 309-A
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City | NASHVILLE
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State | TN
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Zip | 37215-2777
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Country | US
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Telephone | 615-891-4807
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Fax | 615-915-3124
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | MS. CARLA CARPENTER
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Credential | LDO
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Telephone | 615-891-4807
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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 | DPO906
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License Number State | TN
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