Provider Demographics
NPI:1396067765
Name:THE HOUR GLASS L.L.C.
Entity type:Organization
Organization Name:THE HOUR GLASS L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-350-6106
Mailing Address - Street 1:2707 W BROADWAY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-2931
Mailing Address - Country:US
Mailing Address - Phone:509-855-7560
Mailing Address - Fax:509-855-7561
Practice Address - Street 1:2707 W BROADWAY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-2931
Practice Address - Country:US
Practice Address - Phone:509-855-7560
Practice Address - Fax:509-855-7561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602959975156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty