Organization
SHERIDAN OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW E GROSHART O.D. (OWNER)
(307) 672-5516
Entity
Organization
Contact information
Practice address
23 E GRINNELL PLZ, SHERIDAN, WY 82801-3930
(307) 672-5516
(307) 672-7777
Mailing address
23 E GRINNELL PLZ, SHERIDAN, WY 82801-3930
(307) 672-5516
(307) 672-7777
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
185T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106581500
—
WY
Enumeration date
03/14/2006
Last updated
03/19/2014
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