Provider Demographics
NPI:1073254231
Name:EYEWEAR R US LLC
Entity Type:Organization
Organization Name:EYEWEAR R US LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAGNUM
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEN-AIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-368-5844
Mailing Address - Street 1:122 W PALMETTO PARK RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3828
Mailing Address - Country:US
Mailing Address - Phone:561-368-5844
Mailing Address - Fax:561-368-6681
Practice Address - Street 1:122 W PALMETTO PARK RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3828
Practice Address - Country:US
Practice Address - Phone:561-368-5844
Practice Address - Fax:561-368-6681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-04
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty