Basic Information
| Provider Information | |||||||||
| NPI: | 1477574440 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | USV OPTICAL INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HARMON DR | ||||||||
| Address2: | |||||||||
| City: | BLACKWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080125103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562281000 | ||||||||
| FaxNumber: | 8567183572 | ||||||||
| Practice Location | |||||||||
| Address1: | 220 GOLF MILL CTR | ||||||||
| Address2: | |||||||||
| City: | NILES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 607141220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472991366 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2006 | ||||||||
| LastUpdateDate: | 02/05/2020 | ||||||||
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| AuthorizedOfficialLastName: | WOERNER | ||||||||
| AuthorizedOfficialFirstName: | RANDI | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROFESSIONAL RELATIONS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8562281000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | Y | Suppliers | Eyewear Supplier (Equipment, not the service) |
No ID Information.