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Contact Information

EYELINE OPTICAL OF VICKSBURG INC
2449 N FRONTAGE RD
VICKSBURG, MS39180-5177
 Phone: 601-638-7905
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for EYELINE OPTICAL OF VICKSBURG INC

NPI Number 1831307727
LBN Legal business name EYELINE OPTICAL OF VICKSBURG INC
Authorized official RONNIE MONSOUR - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/21/2007
Last updated 10/15/2025 - About 8 months ago
Identifiers
MS Medicaid 00089002
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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