Provider Demographics
NPI:1023258167
Name:GLASSES BY BERRIS INC.
Entity type:Organization
Organization Name:GLASSES BY BERRIS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:216-381-1466
Mailing Address - Street 1:2183 S GREEN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3313
Mailing Address - Country:US
Mailing Address - Phone:216-381-1466
Mailing Address - Fax:216-381-2928
Practice Address - Street 1:2183 S GREEN RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-3313
Practice Address - Country:US
Practice Address - Phone:216-381-1466
Practice Address - Fax:216-381-2928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH859S332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0430280001Medicaid
OH0430280001Medicare NSC