Provider Demographics
NPI:1225521883
Name:EYE OPTICAL SERVICES & MANAGEMENT GROUP INC
Entity Type:Organization
Organization Name:EYE OPTICAL SERVICES & MANAGEMENT GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACTURADORA
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-318-5550
Mailing Address - Street 1:PO BOX 2058
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-2058
Mailing Address - Country:US
Mailing Address - Phone:787-318-5550
Mailing Address - Fax:
Practice Address - Street 1:BO RINCON SECTOR LOMAS
Practice Address - Street 2:CARR 14 KM 72.2 INTERIOR
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-318-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier