Provider Demographics
NPI:1316002363
Name:ARLINGTON OPTOMETRIC GROUP INC
Entity Type:Organization
Organization Name:ARLINGTON OPTOMETRIC GROUP INC
Other - Org Name:CO OP OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:F
Authorized Official - Last Name:SIBER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-724-1274
Mailing Address - Street 1:1354 SOUTH ARLINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306
Mailing Address - Country:US
Mailing Address - Phone:330-724-1274
Mailing Address - Fax:330-724-2540
Practice Address - Street 1:1354 SOUTH ARLINGTON STREET
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306
Practice Address - Country:US
Practice Address - Phone:330-724-1274
Practice Address - Fax:330-724-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0736870001Medicare NSC