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Organization

PILLEN OPTICAL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAWN JACOB SMITH ABO/NCLE (CEO)
(605) 348-2323
Entity
Organization

Contact information

Practice address
409 KANSAS CITY ST, RAPID CITY, SD 57701-8239
(605) 348-2323
(605) 348-6694
Mailing address
409 KANSAS CITY ST, RAPID CITY, SD 57701-8239
(605) 348-2323
(605) 348-6694

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9281160
SD
Enumeration date
11/07/2014
Last updated
09/08/2016
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  • EDI platform