Provider Demographics
NPI:1235330424
Name:LENSAMERICA, INC
Entity Type:Organization
Organization Name:LENSAMERICA, INC
Other - Org Name:SOUTHERN PINES OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-299-9312
Mailing Address - Street 1:332 E SONDLEY DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1151
Mailing Address - Country:US
Mailing Address - Phone:828-299-9312
Mailing Address - Fax:828-299-9312
Practice Address - Street 1:332 E SONDLEY DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1151
Practice Address - Country:US
Practice Address - Phone:828-299-9312
Practice Address - Fax:828-299-9312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000178142332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8801600Medicaid