Provider Demographics
NPI:1275957797
Name:EYEMART EXPRESS LTD
Entity Type:Organization
Organization Name:EYEMART EXPRESS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-997-1583
Mailing Address - Street 1:1345 WESTERN BLVD
Mailing Address - Street 2:SUITE120
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6663
Mailing Address - Country:US
Mailing Address - Phone:910-376-8225
Mailing Address - Fax:910-376-8232
Practice Address - Street 1:1345 WESTERN BLVD
Practice Address - Street 2:SUITE120
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6663
Practice Address - Country:US
Practice Address - Phone:910-376-8225
Practice Address - Fax:910-376-8232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HD BARNES MANAGEMENT, CO.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier