1396878765 NPI number — THOMAS TURTLE OPTICIANS INC.

Table of content: (NPI 1396878765)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396878765 NPI number — THOMAS TURTLE OPTICIANS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS TURTLE 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:
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:
1396878765
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
444 PAYNE AVE
Provider Second Line Business Mailing Address:
P.O. BOX 830
Provider Business Mailing Address City Name:
NORTH TONAWANDA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14120-6902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-693-1280
Provider Business Mailing Address Fax Number:
716-693-1383

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
444 PAYNE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH TONAWANDA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14120-6902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-693-1280
Provider Business Practice Location Address Fax Number:
716-693-1383
Provider Enumeration Date:
03/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TURTLE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
T
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
716-693-1280

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  NY5265 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0597890001 . This is a "MEDICARE DME" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0597890003 . This is a "MEDICARE DME" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00025972201 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000300010003 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000300010001 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: NY5265 . This is a "EYEMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000300010007 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000300010005 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7309539 . This is a "INDEPENDENT HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0597890002 . This is a "MEDICARE DME" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0597890004 . This is a "MEDICARE DME" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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