Provider Demographics
NPI:1659705051
Name:GLASSES CONNECT INC.
Entity Type:Organization
Organization Name:GLASSES CONNECT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-770-9083
Mailing Address - Street 1:5801 SE 24TH ST UNIT 75
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50320-4704
Mailing Address - Country:US
Mailing Address - Phone:515-770-9083
Mailing Address - Fax:
Practice Address - Street 1:5801 SE 24TH ST UNIT 75
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50320-4704
Practice Address - Country:US
Practice Address - Phone:515-770-9083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier