Provider Demographics
NPI:1154522563
Name:PREMIER OPTICS, INC
Entity type:Organization
Organization Name:PREMIER OPTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:TILLMAN
Authorized Official - Last Name:BOHLER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:704-827-0094
Mailing Address - Street 1:119 E HENRY ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-2551
Mailing Address - Country:US
Mailing Address - Phone:704-827-0094
Mailing Address - Fax:704-827-6138
Practice Address - Street 1:119 E HENRY ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-2551
Practice Address - Country:US
Practice Address - Phone:704-827-0094
Practice Address - Fax:704-827-6138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier