Provider Demographics
NPI:1538399696
Name:PRECISION OPTICAL GROUP
Entity type:Organization
Organization Name:PRECISION OPTICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMERIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-782-6685
Mailing Address - Street 1:701 S OAK ST
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-3650
Mailing Address - Country:US
Mailing Address - Phone:641-782-6685
Mailing Address - Fax:641-782-8410
Practice Address - Street 1:701 S OAK ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-3650
Practice Address - Country:US
Practice Address - Phone:641-782-6685
Practice Address - Fax:641-782-8410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier