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LONGE OPTICAL NPI 1770667917


NPI Information

NPI: 1770667917
Provider Name: LONGE OPTICAL
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
7625 SOUTHTOWN CROSSING
FORT WAYNE, IN
ZIP 46816
Phone: (260) 447-3583
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LONGE OPTICAL 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. LONGE OPTICAL NPI is 1770667917. The provider is registered as an organization entity type.

The provider's business location address is:

7625 SOUTHTOWN CROSSING
FORT WAYNE, IN
ZIP 46816-506
Phone: (260) 447-3583
Fax: (260) 441-8276

The provider's authorized official is Larry Kensill .
The authorized official title is Owner and has the following contact phone number (260) 484-2691.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 4/22/2009.


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
1100173460BMEDICAIDINDIANA
20546830007MEDICARE NSCINDIANA

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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