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General NPI Number Information
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NPI Number | 1740948439
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Entity Type | Organization
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Legal Business Name | EYEWEAR COLLECTION LLC
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | CARR. 129, KM. 5.2, PARC. NUEVAS, CALLE E3 #122
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City | ARECIBO
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State | PR
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Zip | 00612
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Country | US
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Telephone | 939-304-3535
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Fax |
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Provider Business Mailing Address
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Address Line | HC 3 BOX 22032
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City | ARECIBO
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State | PR
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Zip | 00612-8514
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Country | US
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Telephone | 939-304-3535
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | REINALDO SANTIAGO
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Credential |
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Telephone | 939-304-3535
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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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