Provider Demographics
NPI:1548435522
Name:ROBINSON OPTICAL CO. INC.
Entity type:Organization
Organization Name:ROBINSON OPTICAL CO. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1318-442-5045
Mailing Address - Street 1:1424 PETERMAN DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3432
Mailing Address - Country:US
Mailing Address - Phone:318-442-5045
Mailing Address - Fax:
Practice Address - Street 1:1424 PETERMAN DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3432
Practice Address - Country:US
Practice Address - Phone:318-442-5045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0301480001Medicare NSC
LA0301480001Medicare UPIN