Provider Demographics
NPI:1962949339
Name:EMPIRE VISION CENTER, INC.
Entity type:Organization
Organization Name:EMPIRE VISION CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-524-6515
Mailing Address - Street 1:PO BOX 418348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8348
Mailing Address - Country:US
Mailing Address - Phone:800-340-0129
Mailing Address - Fax:
Practice Address - Street 1:344 RUSSELL ST
Practice Address - Street 2:UNIT 5
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-5904
Practice Address - Country:US
Practice Address - Phone:413-584-0452
Practice Address - Fax:413-584-0382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier