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General NPI Number Information
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NPI Number | 1831411552
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Entity Type | Organization
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Legal Business Name | EYEZ, INC.
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 991 PEACHTREE INDUSTRIAL BLVD #114
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City | SUWANEE
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State | GA
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Zip | 30024-4291
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Country | US
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Telephone | 770-904-0883
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Fax | 770-904-0884
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Provider Business Mailing Address
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Address Line | 991 PEACHTREE INDUSTRIAL BLVD #114
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City | SUWANEE
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State | GA
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Zip | 30024-4291
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Country | US
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Telephone | 770-904-0883
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Fax | 770-904-0884
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES R REDDY
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Credential | O.D.
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Telephone | 770-904-0883
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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 | OPT0001565
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License Number State | GA
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