1841609468 NPI number — EMERGING VISION INC.

Table of content: DR. RICK MANUEL QUILES M.D. (NPI 1518956184)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841609468 NPI number — EMERGING VISION INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMERGING VISION INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841609468
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3220 S BROADWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINOT
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58701-7331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-852-5200
Provider Business Mailing Address Fax Number:
701-837-0474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3220 S BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINOT
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58701-7331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-852-5200
Provider Business Practice Location Address Fax Number:
701-837-0474
Provider Enumeration Date:
08/07/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SUAREZ
Authorized Official First Name:
FRANCINE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
212-729-5331

Provider Taxonomy Codes

  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)