Provider Demographics
NPI:1093919219
Name:EYE SAVE OPTICAL, INC
Entity Type:Organization
Organization Name:EYE SAVE OPTICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER ACCOUNTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:N
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-735-3937
Mailing Address - Street 1:2801 SOUTH COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-7915
Mailing Address - Country:US
Mailing Address - Phone:985-735-3937
Mailing Address - Fax:985-735-9000
Practice Address - Street 1:2801 SOUTH COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-7915
Practice Address - Country:US
Practice Address - Phone:985-735-3937
Practice Address - Fax:985-735-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1967173Medicaid
LA1967173Medicaid
LA1199320001Medicare ID - Type Unspecified