Provider Demographics
NPI:1730295304
Name:FAMILY OPTICAL INC
Entity Type:Organization
Organization Name:FAMILY OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LYNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:440-243-6644
Mailing Address - Street 1:7350 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4807
Mailing Address - Country:US
Mailing Address - Phone:440-243-6644
Mailing Address - Fax:440-243-8228
Practice Address - Street 1:7350 PEARL RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-4807
Practice Address - Country:US
Practice Address - Phone:440-243-6644
Practice Address - Fax:440-243-8228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0241080001Medicare ID - Type Unspecified