Provider Demographics
NPI:1427764067
Name:K-EYEGLASSES,LLC
Entity type:Organization
Organization Name:K-EYEGLASSES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:JUNG
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:770-757-7147
Mailing Address - Street 1:3131 LAWRENCEVILLE SUWANEE RD STE C3
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6549
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3131 LAWRENCEVILLE SUWANEE RD STE C3
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6549
Practice Address - Country:US
Practice Address - Phone:770-757-7147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:K-EYEGLASSES,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-26
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty