Roger'S Wabash Optical, LLC
Eyewear Supplier (Equipment, not the service) in New Albany, IN. Organization (NPI-2).
NPI number1528065166
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1528065166
- Entity type
- Organization (NPI-2)
- Legal business name
- Roger'S Wabash Optical, LLC
- Organization subpart
- No
- Enumeration date
- Jun 28, 2005
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
Other names
- Wabash Optical (Other Name)
Practice location
612 State StNew Albany, IN 47150-4734
Phone 812-945-0440 · Fax 812-948-2020
Mailing address
612 State StNew Albany, IN 47150-4734
Phone 812-945-0440 · Fax 812-948-2020
Authorized official
Roger Keith Wyatt
President
8129450440
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