Provider Demographics
NPI:1083039747
Name:EUNOIA
Entity Type:Organization
Organization Name:EUNOIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LENS TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:BRISCOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-973-3195
Mailing Address - Street 1:355 D AVENUE
Mailing Address - Street 2:
Mailing Address - City:LIMON
Mailing Address - State:CO
Mailing Address - Zip Code:80828
Mailing Address - Country:US
Mailing Address - Phone:660-973-3195
Mailing Address - Fax:
Practice Address - Street 1:355 D AVENUE
Practice Address - Street 2:
Practice Address - City:LIMON
Practice Address - State:CO
Practice Address - Zip Code:80828
Practice Address - Country:US
Practice Address - Phone:660-973-3195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty