Organization Name: | JCS OPTICAL INC. |
NPI Number: | 1073527073 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD MERLE CLIBER (OWNER) |
Mailing Address: | 100 S Main St Cheboygan |
State: | MI US |
Postal Code: | 497211658 |
Phone Number: | 2316273149 |
Fax Number: | 2316273855 |
NPI Enumeration Date: | 07/28/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332900000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Non-Pharmacy Dispensing Site |
Taxonomy Specialization: | |
Taxonomy Definition: | A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |