Organization Name: | LOUISVILLE OPTOMETRIC CENTERS, III PSC |
NPI Number: | 1285704866 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROD L. RALLO (OWNER AND OPTOMETRIST) |
Mailing Address: | 600 S Main St Salem |
State: | IN US |
Postal Code: | 471671040 |
Phone Number: | 8128832700 |
Fax Number: | 8128832752 |
NPI Enumeration Date: | 11/09/2006 |
NPI Last Update Date: | 02/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 5419240006 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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. |