Provider Demographics
NPI:1780986190
Name:ARTANIA OPTICAL INC
Entity type:Organization
Organization Name:ARTANIA OPTICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERESTORONIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-265-3880
Mailing Address - Street 1:160 N GULPH RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2941
Mailing Address - Country:US
Mailing Address - Phone:610-265-3880
Mailing Address - Fax:
Practice Address - Street 1:160 N GULPH RD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2941
Practice Address - Country:US
Practice Address - Phone:610-265-3880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
11172010OtherAPPLICATION DATE