Provider Demographics
NPI:1578696027
Name:OCULUS, LLC
Entity Type:Organization
Organization Name:OCULUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-409-4565
Mailing Address - Street 1:460 MAIN ST
Mailing Address - Street 2:LENSCRAFTERS
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-2855
Mailing Address - Country:US
Mailing Address - Phone:860-343-6016
Mailing Address - Fax:860-347-4797
Practice Address - Street 1:460 MAIN ST
Practice Address - Street 2:LENSCRAFTERS
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-2855
Practice Address - Country:US
Practice Address - Phone:860-343-6016
Practice Address - Fax:860-347-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty