Provider Demographics
NPI:1386789691
Name:FOR EYES OPTICAL CO, INC
Entity type:Organization
Organization Name:FOR EYES OPTICAL CO, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-325-3276
Mailing Address - Street 1:285 W 74TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5058
Mailing Address - Country:US
Mailing Address - Phone:305-557-9004
Mailing Address - Fax:305-362-2885
Practice Address - Street 1:755 BETHELEHEM PIKE
Practice Address - Street 2:STE. 2
Practice Address - City:MONTGOMERYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18936
Practice Address - Country:US
Practice Address - Phone:215-361-8593
Practice Address - Fax:215-361-8595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001188152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty