National Provider Identifier Database

OLDE TYME OPTICAL
Optician


Contact Information

OLDE TYME OPTICAL
100 N. 8TH ST E.
SUITE 264
EAST SAINT LOUIS, IL62201
Phone: 618-274-2020
Fax:
Website:
Specialty Taxonomy Code
* Optician 156FX1800X

* Indicates primary specialty

NPI Profile & details for OLDE TYME OPTICAL

NPI Number 1659759918
Legal business name
LBN
OLDE TYME OPTICAL
Authorized official DAVID BLISSENBACH - (OWNER)
Entity Organization
Organization subpart Yes
Enumeration date 05/07/2015
Last updated 05/07/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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