Provider Demographics
NPI:1821266834
Name:LOGAN OPTICIANS, INC.
Entity Type:Organization
Organization Name:LOGAN OPTICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DELINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:706-543-7222
Mailing Address - Street 1:740 PRINCE AVE STE 15
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-5903
Mailing Address - Country:US
Mailing Address - Phone:760-543-7222
Mailing Address - Fax:
Practice Address - Street 1:740 PRINCE AVE STE 15
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5903
Practice Address - Country:US
Practice Address - Phone:760-543-7222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALDO000850332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier