Provider Demographics
NPI:1235204363
Name:SAC INC.
Entity Type:Organization
Organization Name:SAC INC.
Other - Org Name:EYE CARE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-252-2020
Mailing Address - Street 1:3801 S NOLAND RD
Mailing Address - Street 2:STE. E
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-3344
Mailing Address - Country:US
Mailing Address - Phone:816-252-2020
Mailing Address - Fax:
Practice Address - Street 1:3801 S NOLAND RD
Practice Address - Street 2:STE. E
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-3344
Practice Address - Country:US
Practice Address - Phone:816-252-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty