RIVERSIDE OPTICAL INC NPI 1225108830

NPI Information

RIVERSIDE OPTICAL INC is an eyewear supplier in Tuscaloosa, AL. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. RIVERSIDE OPTICAL INC NPI is 1225108830. The provider is registered as an organization entity type.

The provider's business location address is:

535 JACK WARNER PKWY NE STE B2
TUSCALOOSA, AL
ZIP 35404-715
Phone: (205) 554-0107
Fax: (205) 554-0198

The provider's authorized official is Ernes Van Johnson .
The authorized official title is PHYSICIAN OWNEROwner and has the following contact phone number (205) 556-4440.

The enumeration date for this NPI number is 11/9/2006 and was last updated on 5/3/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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