TRISTATE OPTICAL INC. NPI 1013903962

NPI Information

TRISTATE OPTICAL, INC. is an eyewear supplier in Fort Wayne, IN. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. TRISTATE OPTICAL, INC. NPI is 1013903962. The provider is registered as an organization entity type.
The provider Is Doing Business As Cunningham Optical One.

The provider's business location address is:

6424 W JEFFERSON BLVD
FORT WAYNE, IN
ZIP 46804-204
Phone: (260) 436-2020
Fax: (260) 436-7628

The provider's authorized official is Jerry L Bradley .
The authorized official title is Vice President and has the following contact phone number (260) 436-2020.

The enumeration date for this NPI number is 9/26/2005 and was last updated on 8/22/2020.

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:

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