Provider Demographics
NPI:1558828483
Name:THRIVE EYES LLC
Entity Type:Organization
Organization Name:THRIVE EYES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRY
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:GOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-549-4838
Mailing Address - Street 1:6280 WELLS AVE
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-9341
Mailing Address - Country:US
Mailing Address - Phone:916-549-4838
Mailing Address - Fax:916-783-8649
Practice Address - Street 1:100 S HARDING BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-3360
Practice Address - Country:US
Practice Address - Phone:916-549-4839
Practice Address - Fax:916-783-8649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty