Organization
RUTLAND OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH N GILMAN (VICE PRESIDENT)
(802) 775-0121
Entity
Organization
Contact information
Practice address
28 CENTER ST, RUTLAND, VT 05701-4015
(802) 775-0121
(802) 747-6680
Mailing address
28 CENTER ST, RUTLAND, VT 05701-4015
(802) 775-0121
(802) 747-6680
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
43
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049454000154
MEDICARE SUPPLIER NUMBER
VT
Enumeration date
05/03/2006
Last updated
01/29/2008
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