Provider Demographics
NPI:1275665051
Name:NORR OPTICAL INC
Entity Type:Organization
Organization Name:NORR OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:NORR
Authorized Official - Suffix:
Authorized Official - Credentials:BOARD CERTIFIED OPTI
Authorized Official - Phone:269-329-5875
Mailing Address - Street 1:3412 W CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024
Mailing Address - Country:US
Mailing Address - Phone:269-329-5875
Mailing Address - Fax:269-329-5879
Practice Address - Street 1:3412 W CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024
Practice Address - Country:US
Practice Address - Phone:269-329-5875
Practice Address - Fax:269-329-5879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0152800003Medicare ID - Type Unspecified