Provider Demographics
NPI:1891856746
Name:AMIN'S OPTICAL
Entity Type:Organization
Organization Name:AMIN'S OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-777-1414
Mailing Address - Street 1:28200 7 MILE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3794
Mailing Address - Country:US
Mailing Address - Phone:248-777-1414
Mailing Address - Fax:
Practice Address - Street 1:28200 7 MILE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3794
Practice Address - Country:US
Practice Address - Phone:248-777-1414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540Q208800OtherBCBS OF MI
MI0345350001Medicare NSC