Organization
SHALEM CONSUMER BRANDS
Active
Other names
deo eyewear
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD COHEN (CEO)
(212) 920-4021
Entity
Organization
Contact information
Practice address
AVENIDA JESS M. FRAGOSO, CAROLINA, PR 00983
(646) 512-0313
Mailing address
67 CALLE ARRECIFE, DORADO, PR 00646-2072
(646) 512-0313
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11223
—
PR
Enumeration date
08/28/2019
Last updated
07/21/2022
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