Provider Demographics
NPI:1023167186
Name:EYE CENTER OPTICAL, INC.
Entity type:Organization
Organization Name:EYE CENTER OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALFRED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-774-7016
Mailing Address - Street 1:33 RIDDELL ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2025
Mailing Address - Country:US
Mailing Address - Phone:413-774-9986
Mailing Address - Fax:413-774-9987
Practice Address - Street 1:33 RIDDELL ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2025
Practice Address - Country:US
Practice Address - Phone:413-774-9986
Practice Address - Fax:413-774-9987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1213520001Medicare ID - Type Unspecified