Provider Demographics
NPI:1801902127
Name:OPTICAL NEI INC
Entity type:Organization
Organization Name:OPTICAL NEI INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-342-3145
Mailing Address - Street 1:200 MIFFLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1982
Mailing Address - Country:US
Mailing Address - Phone:570-342-3145
Mailing Address - Fax:570-344-1309
Practice Address - Street 1:1850 SOUTH TOWNSHIP BOULEVARD
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640
Practice Address - Country:US
Practice Address - Phone:570-654-1641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA18503OtherBS MICHIGAN
PA1018OtherGEISINGER VENDOR
PA287175OtherBLUE SHIELD
OP1837OtherEYEMED
PA44236OtherVBA
PA24783OtherGEISINGER
PA287175OtherFEDERAL BS
51621OtherDAVIS
26396OtherSPECTERA
PA287175Other65 SPECIAL
PA287175OtherFEDERAL BS
51621OtherDAVIS
PA287175OtherBLUE SHIELD
PA287175OtherFEDERAL BS