Provider Demographics
NPI:1700188034
Name:EYE-DEAL OPTICAL INC.
Entity Type:Organization
Organization Name:EYE-DEAL OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER/OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:PIERCED
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:563-557-0995
Mailing Address - Street 1:1950 JOHN F. KENNEDY RD.
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002
Mailing Address - Country:US
Mailing Address - Phone:563-557-0995
Mailing Address - Fax:
Practice Address - Street 1:1950 JOHN F KENNEDY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-3897
Practice Address - Country:US
Practice Address - Phone:563-557-0995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier