Provider Demographics
NPI:1699035972
Name:BARTON PERREIRA RETAIL II, LLC
Entity Type:Organization
Organization Name:BARTON PERREIRA RETAIL II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:615-891-4807
Mailing Address - Street 1:4017 HILLSBORO PIKE
Mailing Address - Street 2:309-A
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2777
Mailing Address - Country:US
Mailing Address - Phone:615-891-4807
Mailing Address - Fax:615-915-3124
Practice Address - Street 1:4017 HILLSBORO PIKE
Practice Address - Street 2:309-A
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2777
Practice Address - Country:US
Practice Address - Phone:615-891-4807
Practice Address - Fax:615-915-3124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPO906332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier