Provider Demographics
NPI:1972938090
Name:OCULUS, LLC
Entity type:Organization
Organization Name:OCULUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-314-2947
Mailing Address - Street 1:72 FARMINGTON AVE
Mailing Address - Street 2:C/O LENSCRAFTERS
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4216
Mailing Address - Country:US
Mailing Address - Phone:860-314-2947
Mailing Address - Fax:
Practice Address - Street 1:72 FARMINGTON AVE
Practice Address - Street 2:C/O LENSCRAFTERS
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4216
Practice Address - Country:US
Practice Address - Phone:860-314-2947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2456152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty