Provider Demographics
NPI:1649221730
Name:SALINE OPTICAL, INC.
Entity Type:Organization
Organization Name:SALINE OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-778-1113
Mailing Address - Street 1:3 MEDICAL PARK DR
Mailing Address - Street 2:SUITE300
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3728
Mailing Address - Country:US
Mailing Address - Phone:501-778-1113
Mailing Address - Fax:501-778-5391
Practice Address - Street 1:3 MEDICAL PARK DR
Practice Address - Street 2:SUITE300
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3728
Practice Address - Country:US
Practice Address - Phone:501-778-1113
Practice Address - Fax:501-778-5391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4167140001OtherDMERC MEDICARE/CIGNA
AR5B790OtherBLUE CROSS BLUE SHEILD
AR4167140001OtherDMERC MEDICARE/CIGNA