Organization
STAR HAVEN INC.
Active
Other names
Sulphur Optical Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES CHRISTOPHER GREGORY (PRESIDENT)
(337) 625-5665
Entity
Organization
Contact information
Practice address
4024 MAPLEWOOD DR, SULPHUR, LA 70663-6354
(337) 625-5665
(337) 625-5665
Mailing address
4024 MAPLEWOOD DR, SULPHUR, LA 70663-6354
(337) 625-5665
(337) 625-5665
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437751
—
LA
Enumeration date
12/18/2006
Last updated
07/27/2007
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