Black & White Look Optical Corp
Ophthalmology in Southfield, MI. Organization (NPI-2).
NPI number1366895005
StatusActive
Last updated in NPPESJul 18, 2016
Details
- NPI
- 1366895005
- Entity type
- Organization (NPI-2)
- Legal business name
- Black & White Look Optical Corp
- Organization subpart
- No
- Enumeration date
- Jul 18, 2016
- Last updated
- Jul 18, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | – | – | Yes |
Practice location
15675 W 10 Mile RdSouthfield, MI 48075-2188
Phone 248-557-6444
Mailing address
15675 W 10 Mile RdSouthfield, MI 48075-2188
Phone 248-557-6444
Authorized official
Patrice Coates
Biller
2482199782
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