Provider Demographics
NPI:1063815710
Name:THE CURATORS OF THE UNIVERSITY OF MISSOURI
Entity Type:Organization
Organization Name:THE CURATORS OF THE UNIVERSITY OF MISSOURI
Other - Org Name:MIZZOU OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-882-1612
Mailing Address - Street 1:3215 WINGATE CT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7214
Mailing Address - Country:US
Mailing Address - Phone:573-884-4568
Mailing Address - Fax:573-884-0025
Practice Address - Street 1:3215 WINGATE CT
Practice Address - Street 2:SUITE 103
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-7214
Practice Address - Country:US
Practice Address - Phone:573-884-4568
Practice Address - Fax:573-884-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier