Provider Demographics
NPI:1063723039
Name:EYEMART EXPRESS
Entity type:Organization
Organization Name:EYEMART EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-488-2002
Mailing Address - Street 1:6180 GLENWAY AVE
Mailing Address - Street 2:UNIT 1C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-6320
Mailing Address - Country:US
Mailing Address - Phone:513-662-0151
Mailing Address - Fax:513-257-0366
Practice Address - Street 1:6180 GLENWAY AVE
Practice Address - Street 2:UNIT 1C
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-6320
Practice Address - Country:US
Practice Address - Phone:513-662-0151
Practice Address - Fax:513-257-0366
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HD BARNES MANAGEMENT, CO.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier