NPI | 1104211838 |
---|---|
Doing Business As | COSTCO OPTICAL #621 |
Entity Type | Organization |
Authorized Contact | ART SALAS A VP Optical 239-433-7240 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL OE1590) |
Enumeration Date | 2015-03-31 |
Last Update Date | 2020-04-02 |