Provider Demographics
NPI:1871747592
Name:BARRE OPTICIANS INC.
Entity type:Organization
Organization Name:BARRE OPTICIANS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:N
Authorized Official - Last Name:IMPERATO
Authorized Official - Suffix:
Authorized Official - Credentials:REG OPTICIAN/HEARIN
Authorized Official - Phone:978-355-2191
Mailing Address - Street 1:PO BOX 783
Mailing Address - Street 2:95 MAIN STREET SOUTH
Mailing Address - City:SOUTH BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01074
Mailing Address - Country:US
Mailing Address - Phone:978-355-2191
Mailing Address - Fax:978-355-2020
Practice Address - Street 1:395 MAIN STREET SOUTH
Practice Address - Street 2:
Practice Address - City:SOUTH BARRE
Practice Address - State:MA
Practice Address - Zip Code:01074
Practice Address - Country:US
Practice Address - Phone:978-355-2191
Practice Address - Fax:978-355-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4043156FC0800X, 237700000X, 332H00000X, 332S00000X, 156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact LensGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
No332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA95162501OtherNETWORK HEALTH
MA1537903Medicaid
MA110028800BOtherMASSHEALTH
MA62431OtherDAVIS VISION
MA18066OtherSPECTERA
MA45806OtherFALLON
MAOP2873OtherEYEMED