Provider Demographics
NPI:1174066526
Name:WEST POINT OPTICAL
Entity type:Organization
Organization Name:WEST POINT OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-545-4465
Mailing Address - Street 1:5030 JONESTOWN RD
Mailing Address - Street 2:RT22
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-2921
Mailing Address - Country:US
Mailing Address - Phone:717-657-0802
Mailing Address - Fax:
Practice Address - Street 1:5030 JONESTOWN RD
Practice Address - Street 2:RT22
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2921
Practice Address - Country:US
Practice Address - Phone:717-657-0802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty