Provider Demographics
NPI:1467661405
Name:TOLEDO OPTICAL LABORATORY, INC.
Entity Type:Organization
Organization Name:TOLEDO OPTICAL LABORATORY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IRLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:TASHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-248-3384
Mailing Address - Street 1:1201 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43624-1836
Mailing Address - Country:US
Mailing Address - Phone:419-248-3384
Mailing Address - Fax:419-321-6361
Practice Address - Street 1:1201 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43624-1836
Practice Address - Country:US
Practice Address - Phone:419-248-3384
Practice Address - Fax:419-321-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH132788332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier