Provider Demographics
NPI:1639583370
Name:WEST POINT OPTICAL N OLMSTEAD
Entity Type:Organization
Organization Name:WEST POINT OPTICAL N OLMSTEAD
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STORE GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WALID
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-734-1030
Mailing Address - Street 1:25102 BROOKPARK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-6414
Mailing Address - Country:US
Mailing Address - Phone:440-734-1030
Mailing Address - Fax:
Practice Address - Street 1:25102 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-6414
Practice Address - Country:US
Practice Address - Phone:440-734-1030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier