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General NPI Number Information
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NPI Number | 1699361444
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Entity Type | Organization
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Legal Business Name | 168 OPTICAL, LLC
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 6656 PEARL RD
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City | PARMA HEIGHTS
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State | OH
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Zip | 44130-3820
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Country | US
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Telephone | 440-613-5222
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Fax |
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Provider Business Mailing Address
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Address Line | 6656 PEARL RD
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City | PARMA HEIGHTS
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State | OH
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Zip | 44130-3820
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Country | US
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Telephone | 440-613-5222
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER LICENSED OPTICIAN
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Name | MRS. AMY JEAN MULLEN
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Credential | ABOC
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Telephone | 440-613-5222
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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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