Provider Demographics
NPI:1154727055
Name:ST. PAUL OPTICIANS, INC.
Entity type:Organization
Organization Name:ST. PAUL OPTICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-738-6800
Mailing Address - Street 1:2080 WOODWINDS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2523
Mailing Address - Country:US
Mailing Address - Phone:651-738-6800
Mailing Address - Fax:651-738-6804
Practice Address - Street 1:5945 NORWICH AVE N
Practice Address - Street 2:
Practice Address - City:OAK PARK HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55082-1290
Practice Address - Country:US
Practice Address - Phone:651-351-2038
Practice Address - Fax:651-342-2530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier