Provider Demographics
NPI:1730418708
Name:EYEMART EXPRESS
Entity type:Organization
Organization Name:EYEMART EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-488-2002
Mailing Address - Street 1:7921 MALL RD
Mailing Address - Street 2:STE B
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1438
Mailing Address - Country:US
Mailing Address - Phone:859-525-0302
Mailing Address - Fax:859-525-0597
Practice Address - Street 1:7921 MALL RD
Practice Address - Street 2:STE B
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1438
Practice Address - Country:US
Practice Address - Phone:859-525-0302
Practice Address - Fax:859-525-0597
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HD BARNES MANAGEMENT,CO.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier