Provider Demographics
NPI:1255469649
Name:IRIS OPTICAL INC
Entity Type:Organization
Organization Name:IRIS OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:VOGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-920-4747
Mailing Address - Street 1:7929 ABERCORN STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3438
Mailing Address - Country:US
Mailing Address - Phone:912-920-4747
Mailing Address - Fax:912-920-8055
Practice Address - Street 1:7929 ABERCORN STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3438
Practice Address - Country:US
Practice Address - Phone:912-920-4747
Practice Address - Fax:912-920-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1586332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier