Provider Demographics
NPI:1326290495
Name:OPTIQUE INC.
Entity Type:Organization
Organization Name:OPTIQUE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:MELGARY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-676-4717
Mailing Address - Street 1:3233 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:OH
Mailing Address - Zip Code:43906-1520
Mailing Address - Country:US
Mailing Address - Phone:740-676-4717
Mailing Address - Fax:740-676-4695
Practice Address - Street 1:3233 BELMONT ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-1520
Practice Address - Country:US
Practice Address - Phone:740-676-4717
Practice Address - Fax:740-676-4695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3515332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1310559OtherUMWA
OH410002650OtherRAILROAD MEDICARE
OH0619307Medicaid
OHME0529172Medicare PIN
OH1310559OtherUMWA
OH0312070001Medicare NSC