Provider Demographics
NPI:1952609984
Name:DESERT EYE OPTICAL LLC
Entity Type:Organization
Organization Name:DESERT EYE OPTICAL LLC
Other - Org Name:DESERT EYE OPTICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-327-5677
Mailing Address - Street 1:1150 S CALLE DE LAS CASITAS
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-2017
Mailing Address - Country:US
Mailing Address - Phone:520-327-5677
Mailing Address - Fax:520-547-2135
Practice Address - Street 1:1150 S CALLE DE LAS CASITAS
Practice Address - Street 2:SUITE 120
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-2017
Practice Address - Country:US
Practice Address - Phone:520-382-2340
Practice Address - Fax:520-625-0648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier