Provider Demographics
NPI:1932383247
Name:EYEWEAR UNIQUE
Entity Type:Organization
Organization Name:EYEWEAR UNIQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:STAIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-271-7356
Mailing Address - Street 1:4008 SW HUNTOON ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1837
Mailing Address - Country:US
Mailing Address - Phone:785-271-7356
Mailing Address - Fax:785-271-5928
Practice Address - Street 1:4008 SW HUNTOON ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1837
Practice Address - Country:US
Practice Address - Phone:785-271-7356
Practice Address - Fax:785-271-5928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS036-F-01332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier