Provider Demographics
NPI:1477658284
Name:A-BOSS OPTICIANS INC
Entity Type:Organization
Organization Name:A-BOSS OPTICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.PRES
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-561-0811
Mailing Address - Street 1:938 BROOKLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226
Mailing Address - Country:US
Mailing Address - Phone:412-561-0811
Mailing Address - Fax:412-563-0759
Practice Address - Street 1:938 BROOKLINE BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15226
Practice Address - Country:US
Practice Address - Phone:412-561-0811
Practice Address - Fax:412-563-0759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA202279OtherBLUE CROSS BLUE SHIELD
PA1007280490003Medicaid
PA0739990002Medicare ID - Type Unspecified