Organization
OLE BROOK OPTICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS T SMITH CERTIFIED OPTICIAN (PRESIDENT)
(601) 833-3318
Entity
Organization
Contact information
Practice address
401 HWY 51 SOUTH, BROOKHAVEN, MS 39601
(601) 833-3318
(601) 833-7782
Mailing address
PO BOX 598, BROOKHAVEN, MS 39601
(601) 833-3318
(601) 833-7782
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07256063
—
MS
Enumeration date
11/20/2006
Last updated
01/15/2010
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