# JAN'S OPTICAL SHOP OF CRYSTAL RIVER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235272337
- **Authorized official:** STACY A CHRISTOPHER (MANAGERING MEMBER)
- **Authorized official phone:** (352) 795-7228

## Contact information

- **Practice address:** 597 SE US HIGHWAY 19, CRYSTAL RIVER, FL 34429-4807
- **Practice address phone:** (352) 795-7228
- **Mailing address:** 597 SE US HIGHWAY 19, CRYSTAL RIVER, FL 34429-4807
- **Mailing address phone:** (352) 795-7228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 02/15/2007
- **Last updated:** 08/22/2020