Provider Demographics
NPI:1588842496
Name:COLLINS OPTICAL CENTER
Entity Type:Organization
Organization Name:COLLINS OPTICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:401-949-5330
Mailing Address - Street 1:3 COMMERCE ST
Mailing Address - Street 2:UNIT 5
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828
Mailing Address - Country:US
Mailing Address - Phone:401-949-5330
Mailing Address - Fax:401-949-1190
Practice Address - Street 1:3 COMMERCE ST
Practice Address - Street 2:UNIT 5
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828
Practice Address - Country:US
Practice Address - Phone:401-949-5330
Practice Address - Fax:401-949-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI72156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI407257OtherBLUE CHIP
RI78803OtherBLUE CROSS BLUE SHIELD
RI407257OtherBLUE CHIP