Organization Name: | POTOSI OPTOMETRIC CENTER |
NPI Number: | 1548385818 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID ORIE ALBERT (PREISENT) |
Mailing Address: | 307 N Missouri St Potosi |
State: | MO US |
Postal Code: | 636641747 |
Phone Number: | 5734383415 |
Fax Number: | 5734387667 |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | T02120 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
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. |