Coliseum Eyewear
Eyewear Supplier (Equipment, not the service) in Winston Salem, NC. Organization (NPI-2).
NPI number1770840514
StatusActive
Last updated in NPPESApr 18, 2012
Details
- NPI
- 1770840514
- Entity type
- Organization (NPI-2)
- Legal business name
- Coliseum Eyewear
- Organization subpart
- No
- Enumeration date
- Apr 18, 2012
- Last updated
- Apr 18, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
Practice location
611 Coliseum DrWinston Salem, NC 27106-5310
Phone 336-397-7200 · Fax 336-757-1202
Mailing address
611 Coliseum DrWinston Salem, NC 27106-5310
Authorized official
Billie T. Litwin
President
3367571120
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