TERRIS FASHION OPTICAL LLC NPI 1669507935

NPI Information

NPI: 1669507935
Provider Name: TERRIS FASHION OPTICAL LLC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
629 W CLOVERLAND DRIVE
SUITE 7
IRONWOOD, MI
ZIP 49938
Phone: (906) 932-0020
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TERRIS FASHION OPTICAL LLC is an eyewear supplier in Ironwood, MI. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. TERRIS FASHION OPTICAL LLC NPI is 1669507935. The provider is registered as an organization entity type.

The provider's business location address is:

629 W CLOVERLAND DRIVE
SUITE 7
IRONWOOD, MI
ZIP 49938-045
Phone: (906) 932-0020
Fax: (906) 932-8057

The provider's authorized official is Terri A Kimball .
The authorized official title is Owner Optician and has the following contact phone number (906) 932-0020.

The enumeration date for this NPI number is 2/23/2007 and was last updated on 7/21/2022.

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		1	MICHIGAN	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	Other Provider Identifier Issuer
1	38723900	MEDICAID	WISCONSIN

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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