Organization
PARK CENTRE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELAINE R NOE OPTICIAN (MANAGER/OWNER)
(330) 335-3881
Entity
Organization
Contact information
Practice address
1 PARK CENTER DR, SUITE 101, WADSWORTH, OH 44281-7100
(330) 335-3881
(330) 334-9085
Mailing address
1 PARK CENTER DR, SUITE 101, WADSWORTH, OH 44281-7100
(330) 335-3881
(330) 334-9085
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
S2805
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0765266
—
OH
Enumeration date
05/23/2008
Last updated
05/23/2008
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