Provider Demographics
NPI:1558338624
Name:UNION OPTICAL SERVICES INC.
Entity Type:Organization
Organization Name:UNION OPTICAL SERVICES INC.
Other - Org Name:UNION OPTICAL PLAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:LOCKHART
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:330-833-1091
Mailing Address - Street 1:915 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-6833
Mailing Address - Country:US
Mailing Address - Phone:330-833-1091
Mailing Address - Fax:330-833-1091
Practice Address - Street 1:915 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-6833
Practice Address - Country:US
Practice Address - Phone:330-833-1091
Practice Address - Fax:330-833-1092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSC-32156FX1800X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8957884Medicaid
OH2642439Medicaid
OH3019665Medicaid