Provider Demographics
NPI:1124116488
Name:OPTICS LTD
Entity type:Organization
Organization Name:OPTICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:G.MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAYYAT
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:802-388-4456
Mailing Address - Street 1:1330 EXCHANGE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-4425
Mailing Address - Country:US
Mailing Address - Phone:802-388-4456
Mailing Address - Fax:803-388-9639
Practice Address - Street 1:1330 EXCHANGE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-4425
Practice Address - Country:US
Practice Address - Phone:802-388-4456
Practice Address - Fax:803-388-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT028-0000176332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0006613Medicaid