Organization
TPB ENTERPRISES, INC
Active
Other names
LILLY EYE CARE, FRAMINGHAM OPTICAL
Organization subpart
No
Provider details
NPI number
Authorized official
TRUNG VAN BUI (DIRECTOR)
(508) 875-9636
Entity
Organization
Contact information
Practice address
545 UNION AVE, FRAMINGHAM, MA 01702-5819
(508) 875-9636
(508) 875-3770
Mailing address
545 UNION AVE, FRAMINGHAM, MA 01702-5819
(508) 875-9636
(508) 875-3770
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4555
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110084466/A
—
MA
01
—
W21101
MEDICARE PTAN
MA
Enumeration date
07/22/2006
Last updated
04/08/2023
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