Organization
COOREY STORES INC
Active
Other names
Optical Warehouse Outlet
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES FIELDS OD (MANGER)
(718) 523-5150
Entity
Organization
Contact information
Practice address
8915 165TH ST, JAMAICA, NY 11432-5153
(718) 523-5150
(718) 523-5212
Mailing address
8915 165TH ST, JAMAICA, NY 11432-5153
(718) 523-5150
(718) 523-5212
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
02145-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01857689
—
NY
Enumeration date
08/28/2009
Last updated
08/28/2009
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