Organization
PROVIDENCE OPTICIANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD M WINSLOW (OWNER/ PRESIDENT)
(202) 462-0055
Entity
Organization
Contact information
Practice address
1802 11TH ST NW, WASHINGTON, DC 20001-5021
(202) 462-0055
(202) 462-2837
Mailing address
1802 11TH ST NW, WASHINGTON, DC 20001-5021
(202) 462-0055
(202) 462-2837
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016707300
—
DC
01
—
1538298906
BLOCK VISION
DC
Enumeration date
01/30/2009
Last updated
01/30/2009
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