Provider Demographics
NPI:1356075345
Name:STRONG OPTICAL SHOP
Entity Type:Organization
Organization Name:STRONG OPTICAL SHOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:M
Authorized Official - Last Name:HETTERICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-756-4008
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 659
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-273-3937
Mailing Address - Fax:585-276-0324
Practice Address - Street 1:875 HARD RD STE 200
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-8949
Practice Address - Country:US
Practice Address - Phone:585-273-3937
Practice Address - Fax:585-671-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier