Provider Demographics
NPI:1366558686
Name:OPTICAL NEI INC
Entity type:Organization
Organization Name:OPTICAL NEI INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-342-3145
Mailing Address - Street 1:200 MIFFLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1982
Mailing Address - Country:US
Mailing Address - Phone:570-342-3145
Mailing Address - Fax:570-344-1309
Practice Address - Street 1:503 S STATE ST
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-1557
Practice Address - Country:US
Practice Address - Phone:570-587-5186
Practice Address - Fax:570-586-7973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA287175OtherFEDERAL BS
PA14236OtherVBA
PA1018OtherGEISINGER
PA287175OtherBLUE SHIELD
PA287175Other65 SPECIAL
OP1837OtherEYEMED
51611OtherDAVIS
26393OtherSPECTERA
PA18503OtherBS MICHIGAN
PA24783OtherGEISINGER VENDOR
=========OtherVSP
PA287175Other65 SPECIAL
26393OtherSPECTERA
51611OtherDAVIS