1871747592 NPI number — BARRE OPTICIANS INC.

Table of content: (NPI 1871747592)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871747592 NPI number — BARRE OPTICIANS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARRE OPTICIANS 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:
BARRE OPTICIANS AND HEARING AID CENTER
Provider Other Organization Name Type Code:
3
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:
1871747592
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 783
Provider Second Line Business Mailing Address:
95 MAIN STREET SOUTH
Provider Business Mailing Address City Name:
SOUTH BARRE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01074
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-355-2191
Provider Business Mailing Address Fax Number:
978-355-2020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
395 MAIN STREET SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH BARRE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01074
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-355-2191
Provider Business Practice Location Address Fax Number:
978-355-2020
Provider Enumeration Date:
11/07/2008

Additional Information

Authorized Official

Authorized Official Last Name:
IMPERATO
Authorized Official First Name:
SALVATORE
Authorized Official Middle Name:
N
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
978-355-2191

Provider Taxonomy Codes

  • Taxonomy code: 156FC0800X , with the licence number:  4043 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1800X , with the licence number: 4043 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237700000X , with the licence number: 4043 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332H00000X , with the licence number: 4043 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332S00000X , with the licence number: 4043 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 95162501 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1537903 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110028800B . This is a "MASSHEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 62431 . This is a "DAVIS VISION" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 18066 . This is a "SPECTERA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 45806 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: OP2873 . This is a "EYEMED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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