Provider Demographics
NPI:1730567561
Name:SUNSTAR OPTICAL
Entity type:Organization
Organization Name:SUNSTAR OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:H
Authorized Official - Last Name:REINHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-739-8880
Mailing Address - Street 1:5960 EDMOND ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2856
Mailing Address - Country:US
Mailing Address - Phone:702-739-8880
Mailing Address - Fax:702-739-7988
Practice Address - Street 1:5960 EDMOND ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2856
Practice Address - Country:US
Practice Address - Phone:702-739-8880
Practice Address - Fax:702-739-7988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier