Organization
DOROTHY HARRIS
Active
Other names
Pine Bluff Optical Company
Organization subpart
No
Provider details
NPI number
Authorized official
FAYE WEST (MANAGER)
(870) 534-8184
Entity
Organization
Contact information
Practice address
3073 W 28TH AVE, PINE BLUFF, AR 71603-4802
(870) 534-8184
(870) 534-8184
Mailing address
3073 W 28TH AVE, PINE BLUFF, AR 71603-4802
(870) 534-8184
(870) 534-8184
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
L8837
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48776
BLUE CROSS BLUE SHIELD
AR
Enumeration date
01/02/2007
Last updated
07/24/2008
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