Organization Name: | CORY EYECARE PTR |
NPI Number: | 1033379987 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIM P CORY (OWNER) |
Mailing Address: | 6509 Central Ave Portage |
State: | IN US |
Postal Code: | 463683101 |
Phone Number: | 2197624801 |
Fax Number: | 2197649974 |
NPI Enumeration Date: | 06/13/2008 |
NPI Last Update Date: | 01/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |