Provider Demographics
NPI:1841059748
Name:BRISTOL YOUR EYES
Entity type:Organization
Organization Name:BRISTOL YOUR EYES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:LO
Authorized Official - Phone:860-589-6475
Mailing Address - Street 1:927 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-3927
Mailing Address - Country:US
Mailing Address - Phone:860-589-6475
Mailing Address - Fax:860-589-7763
Practice Address - Street 1:927 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-3927
Practice Address - Country:US
Practice Address - Phone:860-589-6475
Practice Address - Fax:860-589-7763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier