1487460879 NPI number — ADA & OSH ONLINE ENTERPRISES 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 1487460879 NPI number — ADA & OSH ONLINE ENTERPRISES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADA & OSH ONLINE ENTERPRISES 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:
1487460879
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2280 BARONWOOD DRIVE
Provider Second Line Business Mailing Address:
UNIT 89
Provider Business Mailing Address City Name:
OAKVILLE
Provider Business Mailing Address State Name:
ONTARIO
Provider Business Mailing Address Postal Code:
LGM OK4
Provider Business Mailing Address Country Code:
CA
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:
2280 BARONWOOD DRIVE
Provider Second Line Business Practice Location Address:
UNIT 89
Provider Business Practice Location Address City Name:
OAKVILLE
Provider Business Practice Location Address State Name:
ONTARIO
Provider Business Practice Location Address Postal Code:
LGM OK4
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
437-999-5776
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/10/2024

Additional Information

Authorized Official

Authorized Official Last Name:
IRYMHEKHA
Authorized Official First Name:
ADA
Authorized Official Middle Name:
DANIELLA
Authorized Official Title or Position:
OPTOMETRIST/DIRECTOR
Authorized Official Telephone Number:
437-999-5776

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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