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General NPI Number Information
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NPI Number | 1922077304
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Entity Type | Organization
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Legal Business Name | EYE ASSOCIATES LEASING COMPANY INCORPORATED
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 25 CUNNINGHAM COR
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City | BELLA VISTA
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State | AR
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Zip | 72714-3520
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Country | US
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Telephone | 479-246-1730
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Fax | 479-936-8799
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Provider Business Mailing Address
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Address Line | 3737 W WALNUT ST
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City | ROGERS
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State | AR
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Zip | 72756-1839
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Country | US
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Telephone | 479-246-1730
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Fax | 479-936-8799
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. RANDAL E. COLE
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Credential | M.D.
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Telephone | 479-246-1700
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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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