Organization
SOUTH COUNTRY OPTICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD LEONARD RZEMIENIEWSKI OPHTHALMIC DISPENSER (OWNER VP SEC)
(631) 758-4466
Entity
Organization
Contact information
Practice address
331 E MAIN ST, SUITE 3, PATCHOGUE, NY 11772-3114
(631) 758-4466
(631) 758-4467
Mailing address
331 E MAIN ST, SUITE 3, PATCHOGUE, NY 11772-3114
(631) 758-4466
(631) 758-4467
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
003345
NY
156FX1800X
Optician
004170
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00986865
—
NY
Enumeration date
11/15/2006
Last updated
08/22/2020
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