Provider Demographics
NPI:1467976472
Name:GRIFFLANDS OPTICAL
Entity Type:Organization
Organization Name:GRIFFLANDS OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-513-9178
Mailing Address - Street 1:1951 W GLEN PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GRIFFITH
Mailing Address - State:IN
Mailing Address - Zip Code:46319-3703
Mailing Address - Country:US
Mailing Address - Phone:219-513-9178
Mailing Address - Fax:219-237-2067
Practice Address - Street 1:1951 WEST GLEN PARK AVE
Practice Address - Street 2:
Practice Address - City:GRIFFITH
Practice Address - State:IN
Practice Address - Zip Code:46319
Practice Address - Country:US
Practice Address - Phone:219-513-9178
Practice Address - Fax:219-237-2067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier