LONGE OPTICAL INC NPI 1396798963

NPI Information

NPI: 1396798963
Provider Name: LONGE OPTICAL INC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
3409 N ANTHONY BLVD
FT WAYNE, IN
ZIP 46805
Phone: (260) 484-2691
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LONGE OPTICAL INC is an eyewear supplier in Ft Wayne, IN. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. LONGE OPTICAL INC NPI is 1396798963. The provider is registered as an organization entity type.

The provider's business location address is:

3409 N ANTHONY BLVD
FT WAYNE, IN
ZIP 46805
Phone: (260) 484-2691

The provider's authorized official is Martha C Davenport .
The authorized official title is Office Manager and has the following contact phone number (260) 347-1128.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 1/28/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332H00000X	Eyewear Supplier			INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0546830001	MEDICARE NSC	INDIANA
2	100173460	MEDICAID	INDIANA
3	511240	MEDICARE PIN
4	100173460E	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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