Provider Demographics
NPI:1073527073
Name:JCS OPTICAL INC.
Entity Type:Organization
Organization Name:JCS OPTICAL INC.
Other - Org Name:NEW VISION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MERLE
Authorized Official - Last Name:CLIBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-487-1669
Mailing Address - Street 1:220 LYNN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-2662
Mailing Address - Country:US
Mailing Address - Phone:810-487-1669
Mailing Address - Fax:810-605-0610
Practice Address - Street 1:100 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-1658
Practice Address - Country:US
Practice Address - Phone:231-627-3149
Practice Address - Fax:231-627-3855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332900000XSuppliersNon-Pharmacy Dispensing Site
Not Answered332H00000XSuppliersEyewear Supplier