Provider Demographics
NPI:1598219685
Name:KID GLASSES, INC.
Entity Type:Organization
Organization Name:KID GLASSES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-692-5205
Mailing Address - Street 1:435 S BUCHANAN ST STE B
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-2091
Mailing Address - Country:US
Mailing Address - Phone:618-692-5205
Mailing Address - Fax:618-692-5206
Practice Address - Street 1:435 S BUCHANAN ST STE B
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-2091
Practice Address - Country:US
Practice Address - Phone:618-692-5205
Practice Address - Fax:618-692-5206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-07
Last Update Date:2016-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier