1326249863 NPI number — LE ANNES EYE WEAR INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326249863 NPI number — LE ANNES EYE WEAR INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LE ANNES EYE WEAR 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:
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:
1326249863
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2733 CHEROKEE ST
Provider Second Line Business Mailing Address:
LE ANNES EYE WEAR INC
Provider Business Mailing Address City Name:
ST LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2733 CHEROKEE ST
Provider Second Line Business Practice Location Address:
LE ANNES EYE WEAR INC
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-773-7116
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
LOU
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
314-773-7116

Provider Taxonomy Codes

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

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

  • Identifier: 322330515 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com