Provider Demographics
NPI:1942308853
Name:STAR OPTICAL
Entity Type:Organization
Organization Name:STAR OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:RILEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-731-9888
Mailing Address - Street 1:929 WOOD STREET
Mailing Address - Street 2:
Mailing Address - City:WILKINSURG
Mailing Address - State:PA
Mailing Address - Zip Code:15221
Mailing Address - Country:US
Mailing Address - Phone:412-731-9888
Mailing Address - Fax:412-731-9846
Practice Address - Street 1:929 WOOD STREET
Practice Address - Street 2:
Practice Address - City:WILKINSURG
Practice Address - State:PA
Practice Address - Zip Code:15221
Practice Address - Country:US
Practice Address - Phone:412-731-9888
Practice Address - Fax:412-731-9846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Multi-Specialty
Not Answered332H00000XSuppliersEyewear Supplier