Provider Demographics
NPI:1124178678
Name:GREENFIELD OPTICAL
Entity Type:Organization
Organization Name:GREENFIELD OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:P
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-557-1812
Mailing Address - Street 1:26615 GREENFIELD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-7028
Mailing Address - Country:US
Mailing Address - Phone:248-557-1512
Mailing Address - Fax:248-557-4984
Practice Address - Street 1:26615 GREENFIELD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-7028
Practice Address - Country:US
Practice Address - Phone:248-557-1512
Practice Address - Fax:248-557-4984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty