PROVIDENCE OPTICIANS DESIGNER EYEWEAR INC (NPI# 1790923605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790923605 |
Entity Type | Organization |
Organization Name | PROVIDENCE OPTICIANS DESIGNER EYEWEAR INC |
Other Organization Name | PROVIDENCE OPTICIANS INC |
Practice Address |
3510 12th St Ne Washington DC 20017-2544 |
Practice Telephone | 2025260300 |
Practice Fax Number | 2025260233 |
Mailing Telephone | 2025260300 |
Mailing Fax Number | 2025260233 |
Enumeration Date | 2009-01-30 |
Last Update Date | 2013-01-24 |
Authorized Official Name | KYLE E. WINSLOW (PRESIDENT) |
Authorized Official Telephone | 2024620055 |
Authorized Official Credential | OPTICIAN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
DC | 016707300 | 05 | |
DC | BLOCK VISION | 1538298906 | 01 |
DC | DAVIS VISION | 61444 | 01 |
Other Name | Type Code |
---|---|
Providence Opticians Inc | Former Legal Business Name - Organization |
Street Address |
3510 12TH ST NE |
City | WASHINGTON |
State | DC |
Zip Code | 20017-2544 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588215479 | Janet Achankeng Folem | Psychologist | 7100 Varnum St Ne, Suit 218, Washington, DC 20017 | 2019-09-23 |
1013475284 | Raphaelia Agnes Johnson-phillips | Technician | 440 Taylor St. Ne Building B Apt 22, Washington Dc, DC 20017 | 2019-03-06 |
1528551413 | Harpreet Saluja | Student in an Organized Health Care Education/Training Program | 1150 Varnum St Ne, Providence Hospital Im Department, Washington, DC 20017 | 2018-06-14 |
1134638042 | Jane Hayashi-kim | Speech-Language Pathologist | 3910 9th St Ne, Apartment 3, Washington, DC 20017 | 2017-09-22 |
1346766102 | Aaliyah Gabrielle Jones | Technician | 611edgewood Ne, Washington, DC 20017 | 2017-08-14 |
1417479197 | Javalin Singh | Home Health Aide | Hsc Pediatric Center 1731 Bunker Hill Rd, Washington, DC 20017 | 2017-07-13 |
1386174175 | Genevieve Wells | Home Health Aide | 601 Edgewood St. Ne, Apt 706, Washington, DC 20017 | 2017-06-14 |
1487183810 | Valerie Anne Pierre | Student in an Organized Health Care Education/Training Program | 1150 Varnum Street, N.e., Acc 209, Washington, DC 20017 | 2017-06-08 |
1639600984 | Liliana Tatum | Counselor | 1428 Hamlin Street Ne, Washington, DC 20017 | 2017-03-27 |
1750835435 | Marie Hortense Mabou Sando | Home Health Aide | 1416 9th Street Nwdc, Washington, DC 20017 | 2016-08-10 |
Find all providers in zip 20017 |
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 |
---|---|---|---|---|
1760909014 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3225 M St Nw, Washington, DC 20007-3616 | 2017-08-28 |
1912432436 | Mcclain Eyewear | Eyewear Supplier (Equipment, not the service) | 1514 U Street Nw, Washington, DC 20009 | 2017-04-21 |
1497294730 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 2460 Market Street Ne, Suite 705, Washington, DC 20018 | 2017-02-20 |
1366734527 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 120 Trinity Point Dr, Washington, PA 15301 | 2011-05-06 |
1861626988 | Focal Point Optical Inc | Eyewear Supplier (Equipment, not the service) | 7828 Eastern Ave Nw Ste 101, Washington, DC 20012-1303 | 2009-05-04 |
1912140757 | Coventry Optical, P.C. | Eyewear Supplier (Equipment, not the service) | 10 Brass Castle Rd, Washington, NJ 07882-6309 | 2009-04-09 |
1689853814 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 1130 Connecticut Ave, Ste #110, Washington, DC 20036-3904 | 2007-10-24 |
1417002858 | Bauman and Stoleru Mdpc | Eyewear Supplier (Equipment, not the service) | 4119 Connecticut Ave Nw, Washington, DC 20008-1155 | 2007-01-24 |
1245384932 | For Eyes Optical of Pa | Eyewear Supplier (Equipment, not the service) | 1725 K St Nw, Washington, DC 20006-1401 | 2007-01-22 |
1538211412 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 1500 W Chestnut St Ste 1, Washington, PA 15301 | 2007-01-18 |
Find all providers in WASHINGTON |
City | WASHINGTON |
Zip Code | 20017 |
Please comment or provide details below to improve the information on PROVIDENCE OPTICIANS DESIGNER EYEWEAR INC.
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.