GRAND LAKE OPTICAL, LLC; NPI #1649383191

Contact Information

GRAND LAKE OPTICAL, LLC

1120 NEO LOOP
GROVE, OK 74344

Phone: 918-787-2121
Fax: 918-787-6002
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Eyewear Supplier	332H00000X	87	All Other Suppliers

Indicates primary specialty

Edit contact information

NPI Profile & details for GRAND LAKE OPTICAL, LLC

NPI # 1649383191

LBN Legal business name GRAND LAKE OPTICAL, LLC

Authorized official KEVIN TOLLER - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/17/2006

Last updated 11/18/2010 - About 16 years ago

Identifiers

Medicaid

200005980A

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.

Reviews for GRAND LAKE OPTICAL, LLC

Thanks - Your review has been submitted! Please note that if we find that this review has violated our terms or is simply deemed unacceptable, we will remove it without notice.

There are currently no reviews for GRAND LAKE OPTICAL, LLC
Be the first to post a comment or review.

Read our reviews / comments about this provider to help you decide if they are right for you. Share your experience by posting a comment or review about this provider to help others decide which is right for them.

Nearby Suppliers

NORTHEASTERN STATE UNIVERSITY COLLEGE OF OPTOMETRY
1015 WASHBOURNE
JAY, OK

WAL-MART STORES EAST LP
100 COMMERCIAL DR
PINEVILLE, MO

RHEAGAN D BALLARD, M.S., CCC-SLP
201 N 5TH AVE
ACHILLE, OK

CHARLES W LINDELL
107 E BEECH
ACHILLE, OK

AKEEMIA L HOLDER
YOUTH CARE OF OKLAHOMA
713 SW C AVENUE, OK

ACELLERATED INTERVENTIONAL ORTHOPEDICS
3414 NW CACHE
LAWTON, OK

View all Suppliers

GRAND LAKE OPTICAL, LLC

Contact Information

Specialty

Eyewear Supplier

NPI Profile & details for GRAND LAKE OPTICAL, LLC

Reviews for GRAND LAKE OPTICAL, LLC