Provider Demographics
NPI:1376754317
Name:SAFE-LITE OPTICAL COMPANY, INC.
Entity Type:Organization
Organization Name:SAFE-LITE OPTICAL COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:'DEANE'
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-399-3690
Mailing Address - Street 1:2229 VINSON LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-7262
Mailing Address - Country:US
Mailing Address - Phone:904-399-3690
Mailing Address - Fax:904-398-8859
Practice Address - Street 1:2229 VINSON LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-7262
Practice Address - Country:US
Practice Address - Phone:904-399-3690
Practice Address - Fax:904-398-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier