Provider Demographics
NPI:1326683996
Name:QUALITY OPTICAL LLC
Entity Type:Organization
Organization Name:QUALITY OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAWORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-276-7217
Mailing Address - Street 1:806 N OLD WORLD 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53203-1701
Mailing Address - Country:US
Mailing Address - Phone:414-276-7217
Mailing Address - Fax:
Practice Address - Street 1:806 N OLD WORLD 3RD ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53203-1701
Practice Address - Country:US
Practice Address - Phone:414-276-7217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty