Provider Demographics
NPI:1639360373
Name:SPECTROPTICS INC
Entity Type:Organization
Organization Name:SPECTROPTICS INC
Other - Org Name:SPECTRUM OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:BOARD CERT OPTICIAN
Authorized Official - Phone:352-378-3261
Mailing Address - Street 1:3654 SW ARCHER RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-2413
Mailing Address - Country:US
Mailing Address - Phone:352-378-3261
Mailing Address - Fax:352-378-1915
Practice Address - Street 1:3654 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-2413
Practice Address - Country:US
Practice Address - Phone:352-378-3261
Practice Address - Fax:352-378-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0954380001Medicare NSC