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Organization

NATIONAL EYEWEAR OUTLET OF WARREN

Active
Other names
National Discount Eyewear
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHERRIE ANN HICKS (VICE PRESIDENT-OPTICIAN)
(586) 558-3059
Entity
Organization

Contact information

Practice address
3200 E 12 MILE RD, SUITE 104, WARREN, MI 48092-5621
(586) 558-3059
(586) 558-3067
Mailing address
3200 E 12 MILE RD, SUITE 104, WARREN, MI 48092-5621
(586) 558-3059
(586) 558-3067

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
B
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
147096
COLE MANAGED VISION
MI
01
233194
NVA
MI
01
CP1749
EYEMED LOCATION
MI
01
MI2556
EYEMED DR
MI
01
OP1347
EYEMED SHERRIE
MI
01
OP1348
EYEMED GARY
MI
Enumeration date
01/29/2007
Last updated
07/21/2022
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