Provider Demographics
NPI:1699822627
Name:CAMPUS OPTICAL
Entity Type:Organization
Organization Name:CAMPUS OPTICAL
Other - Org Name:EYE STYLES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PLASSE
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:614-326-2020
Mailing Address - Street 1:4729 REED ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220
Mailing Address - Country:US
Mailing Address - Phone:614-326-2020
Mailing Address - Fax:614-457-9767
Practice Address - Street 1:4729 REED ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220
Practice Address - Country:US
Practice Address - Phone:614-326-2020
Practice Address - Fax:614-457-9767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3977152W00000X
OHOH4703152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty