Organization
HERITAGE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES P. THEROUX (OPTOMETRIST)
(401) 762-5599
Entity
Organization
Contact information
Practice address
255 CASS AVE, WOONSOCKET, RI 02895-4705
(401) 762-5599
Mailing address
255 CASS AVE, WOONSOCKET, RI 02895-4705
(401) 762-5599
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30231973
NEIGHBORHOOD HEALTH PLAN
RI
01
—
38061
DAVIS VISION
RI
01
—
4017625599
VISION SERVICE PLAN
RI
05
—
9007936
—
RI
Enumeration date
07/19/2006
Last updated
08/22/2020
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