Provider Demographics
NPI:1366463002
Name:OPTICAL MANAGEMENT SYSTEMS, INC.
Entity type:Organization
Organization Name:OPTICAL MANAGEMENT SYSTEMS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:313-563-5121
Mailing Address - Street 1:2222 N BEECH DALY RD
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3491
Mailing Address - Country:US
Mailing Address - Phone:313-563-5121
Mailing Address - Fax:313-563-5179
Practice Address - Street 1:G4325 MILLER ROAD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1216
Practice Address - Country:US
Practice Address - Phone:810-230-9292
Practice Address - Fax:810-230-7841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002165152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION36230OtherMEDICARE PART B
MI0521460011Medicare NSC