Organization
ANGELA MIMS
Active
Other names
MILFORD FAMILY OPTICAL
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MIMS (OWNER/OPTICIAN)
(570) 409-8282
Entity
Organization
Contact information
Practice address
104 BENNETT AVE, SUITE 2A-1, MILFORD, PA 18337-9759
(570) 409-8282
(570) 409-8283
Mailing address
104 BENNETT AVE, SUITE 2A-1, MILFORD, PA 18337-9759
(570) 409-8282
(570) 409-8283
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6000006134
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019415530001
—
PA
Enumeration date
09/22/2006
Last updated
08/22/2020
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