TRI-STATE OPTICAL, INC. (NPI# 1205822145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205822145 |
Entity Type | Organization |
Organization Name | TRI-STATE OPTICAL, INC. |
Other Organization Name | CUNNINGHAM OPTICAL ONE |
Practice Address |
5233 Coldwater Rd Fort Wayne IN 46825-5538 |
Practice Telephone | 2604821555 |
Practice Fax Number | 2604838287 |
Mailing Telephone | 2604821555 |
Mailing Fax Number | 2604838287 |
Enumeration Date | 2005-09-26 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. JERRY L BRADLEY (VICE PRESIDENT) |
Authorized Official Telephone | 2604821555 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
Other Name | Type Code |
---|---|
Cunningham Optical One | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275529125 | Tri-state Optical, Inc. | Eyewear Supplier (Equipment, not the service) | 5600-a East Virgina Street, Evansville, IN 47715-2639 | 2005-09-26 |
Street Address |
5233 COLDWATER RD |
City | FORT WAYNE |
State | IN |
Zip Code | 46825-5538 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
Find all providers in zip 46825 |
Taxonomy Code | 332H00000X |
Grouping | Suppliers |
Classification | Eyewear Supplier (Equipment, not the service) |
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760993810 | Longe Enterprises Corp | Eyewear Supplier (Equipment, not the service) | 5711 Ymca Park Dr East, Fort Wayne, IN 46835 | 2017-10-17 |
1881927317 | Longe Optical-north Inc | Eyewear Supplier (Equipment, not the service) | 4534 Maplecrest Rd, Fort Wayne, IN 46835-3970 | 2009-09-16 |
1700932415 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 333 East Coliseum Boulevard, Fort Wayne, IN 46805 | 2007-01-26 |
1770667917 | Longe Optical | Eyewear Supplier (Equipment, not the service) | 7625 Southtown Crossing, Fort Wayne, IN 46816-2506 | 2006-10-24 |
1649293903 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 4201 Coldwater Road, Fort Wayne, IN 46805 | 2006-07-26 |
1013903962 | Tristate Optical, Inc. | Eyewear Supplier (Equipment, not the service) | 6424 W Jefferson Blvd, Fort Wayne, IN 46804-6204 | 2005-09-26 |
1528584562 | Eyecare Express | Eyewear Supplier (Equipment, not the service) | 700 E Coliseum Blvd, Fort Wayne, IN 46805-1220 | 2017-08-22 |
1477944510 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 5110 Value Dr, Fort Wayne, IN 46808-4048 | 2015-02-11 |
1194123026 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 515 E Coliseum Blvd, Fort Wayne, IN 46805-1215 | 2014-12-09 |
1013255884 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 6309 Lima Rd, Fort Wayne, IN 46818-1425 | 2013-01-29 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46825 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.