Provider Demographics
NPI:1598882011
Name:STURGIS OPTICAL COMPANY
Entity Type:Organization
Organization Name:STURGIS OPTICAL COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARSENIO
Authorized Official - Middle Name:T
Authorized Official - Last Name:PARIAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-651-7808
Mailing Address - Street 1:600 S LAKEVIEW AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-2399
Mailing Address - Country:US
Mailing Address - Phone:269-651-7808
Mailing Address - Fax:
Practice Address - Street 1:600 S LAKEVIEW AVE
Practice Address - Street 2:STE 102
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-2399
Practice Address - Country:US
Practice Address - Phone:269-651-7808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0345270001Medicare NSC