Provider Demographics
NPI:1982823449
Name:GINGER CROWE
Entity Type:Organization
Organization Name:GINGER CROWE
Other - Org Name:CONTACT LENSES UNLIMITED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:LO
Authorized Official - Phone:860-633-1842
Mailing Address - Street 1:39 NEW LONDON TPKE
Mailing Address - Street 2:GLEN LODEN CTR
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033
Mailing Address - Country:US
Mailing Address - Phone:860-633-1842
Mailing Address - Fax:
Practice Address - Street 1:39 NEW LONDON TPKE
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2061
Practice Address - Country:US
Practice Address - Phone:860-633-1842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1035332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier