Provider Demographics
NPI:1982710208
Name:OPTICAL NEI INC
Entity Type:Organization
Organization Name:OPTICAL NEI INC
Other - Org Name:TOWN & COUNTRY OPTICAL
Other - Org Type:Former Legal Business Name
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 1:1582 MAIN ST
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-2029
Practice Address - Country:US
Practice Address - Phone:570-489-4430
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
PA287175OtherFEDERAL BS
OP1837OtherEYEMED
PA1018OtherGEISINGER VENDOR
PA24783OtherGEISINGER
PA42360OtherVBA
PA296613OtherFEDERAL BS
PA287175OtherBLUE SHIELD
PA296613Other65 SPECIAL
51617OtherDAVIS
26399OtherSPECTERA
PA287175Other65 SPECIAL
PA18503OtherBS MICHIGAN
OP1837OtherEYEMED
26399OtherSPECTERA
PA287175OtherBLUE SHIELD
PA=========OtherFIRST PRIORITY