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PACIFIC EYEWEAR INC NPI 1629280284


NPI Information

NPI: 1629280284
Provider Name: PACIFIC EYEWEAR INC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization

CLIA Number: 12D2043121

Address:
4418 KUKUI GROVE ST
LIHUE, HI
ZIP 96766
Phone: (808) 245-5377
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PACIFIC EYEWEAR INC is an eyewear supplier in Lihue, HI. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. PACIFIC EYEWEAR INC NPI is 1629280284. The provider is registered as an organization entity type.

The provider's business location address is:

4418 KUKUI GROVE ST
LIHUE, HI
ZIP 96766-676
Phone: (808) 245-5377
Fax: (808) 245-6142

The provider's authorized official is Larry Sherrer .
The authorized official title is Owner and has the following contact phone number (808) 245-5377.

The CLIA number assigned to this NPI record is 12D2043121 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 12/19/2007.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332H00000XEyewear SupplierYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1055164-01MEDICAIDHAWAII
25307260001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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