Provider Demographics
NPI:1295927325
Name:MILLS OPTICAL COMPANY
Entity type:Organization
Organization Name:MILLS OPTICAL COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNEROPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-267-5151
Mailing Address - Street 1:610 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-2851
Mailing Address - Country:US
Mailing Address - Phone:432-267-5151
Mailing Address - Fax:
Practice Address - Street 1:610 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-2851
Practice Address - Country:US
Practice Address - Phone:432-267-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0902180001Medicare NSC