Provider Demographics
NPI:1508042938
Name:OPTICAL WORLD
Entity Type:Organization
Organization Name:OPTICAL WORLD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-943-5115
Mailing Address - Street 1:815 N MCKENZIE ST STE B
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-3518
Mailing Address - Country:US
Mailing Address - Phone:251-943-5115
Mailing Address - Fax:251-943-5117
Practice Address - Street 1:815 N MCKENZIE ST STE B
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-3518
Practice Address - Country:US
Practice Address - Phone:251-943-5115
Practice Address - Fax:251-943-5117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4217350001Medicare NSC