Provider Demographics
NPI:1992983225
Name:EYEGLASS WORLD #95
Entity type:Organization
Organization Name:EYEGLASS WORLD #95
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-965-9110
Mailing Address - Street 1:3801 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4140
Mailing Address - Country:US
Mailing Address - Phone:561-965-9110
Mailing Address - Fax:561-642-4063
Practice Address - Street 1:8236 LEE VISTA BLVD
Practice Address - Street 2:SUITE A4 - A6
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829
Practice Address - Country:US
Practice Address - Phone:800-584-4150
Practice Address - Fax:561-642-4063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier