Provider Demographics
NPI:1790175818
Name:QUALITY OPTICAL SERVICE INC.
Entity Type:Organization
Organization Name:QUALITY OPTICAL SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JASPER
Authorized Official - Last Name:GRANDY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:561-585-6472
Mailing Address - Street 1:6301 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-4217
Mailing Address - Country:US
Mailing Address - Phone:561-585-6472
Mailing Address - Fax:
Practice Address - Street 1:6301 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-4217
Practice Address - Country:US
Practice Address - Phone:561-585-6472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier