Provider Demographics
NPI:1053736504
Name:EYEMART EXPRESS LTD
Entity type:Organization
Organization Name:EYEMART EXPRESS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-997-1583
Mailing Address - Street 1:1220 N COLUMBIA CENTER BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1117
Mailing Address - Country:US
Mailing Address - Phone:509-591-9020
Mailing Address - Fax:509-591-9841
Practice Address - Street 1:1220 N COLUMBIA CENTER BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1117
Practice Address - Country:US
Practice Address - Phone:509-591-9020
Practice Address - Fax:509-591-9841
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HD BARNES MANAGEMENT, CO.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier