OLE BROOK OPTICAL, INC; NPI #1568536415

Contact Information

OLE BROOK OPTICAL, INC

401 HWY 51 SOUTH
BROOKHAVEN, MS 39601

Phone: 601-833-3318
Fax: 601-833-7782
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Eyewear Supplier	332H00000X	87	All Other Suppliers
Durable Medical Equipment & Medical Supplies	332B00000X	54	Other Medical Supply Company

Indicates primary specialty

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NPI Profile & details for OLE BROOK OPTICAL, INC

NPI # 1568536415

LBN Legal business name OLE BROOK OPTICAL, INC

Authorized official THOMAS SMITH - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/20/2006

Last updated 01/15/2010 - About 16 years ago

Identifiers

Medicaid

07256063

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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