Provider Demographics
NPI:1619085883
Name:OPTICAL ILLUSIONS OF FRANKLIN, INC.
Entity Type:Organization
Organization Name:OPTICAL ILLUSIONS OF FRANKLIN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:E
Authorized Official - Last Name:HENSZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-369-8285
Mailing Address - Street 1:36 WESTGATE PLZ
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-1422
Mailing Address - Country:US
Mailing Address - Phone:828-369-8285
Mailing Address - Fax:
Practice Address - Street 1:36 WESTGATE PLZ
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-1422
Practice Address - Country:US
Practice Address - Phone:828-369-8285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC514332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12051OtherHEALTH CHOICE
NC8801803Medicaid
NC0274280001Medicare ID - Type Unspecified