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General NPI Number Information
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NPI Number | 1700223880
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Entity Type | Organization
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Legal Business Name | EYEMART EXPRESS LTD
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Dates
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Enumeration Date | 05/29/2013
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 1236 N EISENHOWER DR
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City | BECKLEY
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State | WV
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Zip | 25801-3120
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Country | US
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Telephone | 304-250-4995
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Fax | 304-461-7644
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Provider Business Mailing Address
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Address Line | 520 8TH AVE SUITE 900
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City | NEW YORK
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State | NY
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Zip | 10018-6507
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Country | US
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Telephone | 212-729-5344
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Fax | 646-448-3326
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Authorized Official
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Title or Position | DIRECTOR OF MANAGED CARE
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Name | KAREN PITTMAN
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Credential |
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Telephone | 972-488-2002
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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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