Provider Demographics
NPI:1376831313
Name:EYEMART EXPRESS LTD
Entity Type:Organization
Organization Name:EYEMART EXPRESS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-488-2002
Mailing Address - Street 1:11 BANGOR MALL BLVD
Mailing Address - Street 2:UNIT H
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3650
Mailing Address - Country:US
Mailing Address - Phone:207-947-2442
Mailing Address - Fax:207-947-2432
Practice Address - Street 1:11 BANGOR MALL BLVD
Practice Address - Street 2:UNIT H
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3650
Practice Address - Country:US
Practice Address - Phone:207-947-2442
Practice Address - Fax:207-947-2432
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HD BARNES MANAGEMENT, CO.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier