Eyemart Express LLC

NPI #1487162061 in Dothan, Alabama

Provider Information

NPI Number: 1487162061
Entity Type: Organization
Organization Name: Eyemart Express LLC
Subpart: Yes (part of a larger organization)
Parent Organization: EYEMART EXPRESS LLC
Primary Specialty: Eyewear Supplier
Enumeration Date: Jan 17, 2018
Last Updated: Jan 17, 2018

Practice Location

Address: 3201 MONTGOMERY HWY STE 1
City: Dothan
State: Alabama
ZIP Code: 36303-2113
Phone: (334) 350-5315

Authorized Official

Name: KIM CARUSO
Title: DIRECTOR OF CREDENTIALING
Phone: (212) 792-8136

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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