Provider Demographics
NPI:1891932067
Name:EYEMART EXPRESS, LTD.
Entity Type:Organization
Organization Name:EYEMART EXPRESS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MVC
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-488-2002
Mailing Address - Street 1:215 E UNIVERSITY DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-4000
Mailing Address - Country:US
Mailing Address - Phone:574-271-7408
Mailing Address - Fax:574-271-7541
Practice Address - Street 1:215 E UNIVERSITY DR
Practice Address - Street 2:SUITE 150
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-4000
Practice Address - Country:US
Practice Address - Phone:574-271-7408
Practice Address - Fax:574-271-7541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies