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GRAND LAKE OPTICAL, LLC
NPI 1649383191
Eyewear Supplier in Grove, OK

Active since August 17, 2006
1120 NEO LOOP, GROVE, OK 74344(918) 787-2121(918) 787-6002 Get Directions Write a Review

NPPES record last updated: November 18, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Grand Lake Optical, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND LAKE OPTICAL, LLC (NPI 1649383191) is a healthcare organization registered as an eyewear supplier in Grove, Oklahoma and active in the NPI registry since August 2006. The organization lists Kevin K Toller, President, as its authorized official.

NPPES Registry Identity

NPI1649383191
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameGRAND LAKE OPTICAL, LLC
Location Address1120 NEO LOOPGrove, OK 74344
Mailing AddressP.o. Box 451627Grove, OK 74345 · (918) 787-2121 · Fax (918) 787-6002
Phone(918) 787-2121
Fax(918) 787-6002
Organization SubpartNo
Authorized OfficialKevin K TollerPresident · (918) 787-2020
Enumeration DateAugust 17, 2006
Last NPPES UpdateNovember 18, 2010
✔ NPI 1649383191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
1120 NEO LOOP, Grove, OK 74344
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Other Identifiers 3

Medicaid200005980AOK
Medicare PIN1649383191OK
Medicare NSC3910810001OK

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRAND LAKE EYE CARE, PC
Specialist
1120 NEO LOOP
GROVE, OK 74344
Delaware County (918) 787-2020
GOOD SHEPHERD HOSPICE INC
Hospice Care, Community Based
1120 NEO LOOP
GROVE, OK 74344
Delaware County (918) 786-6182
DR. KEVIN KEITH TOLLER MD
Ophthalmology
1120 NEO LOOP
GROVE, OK 74344
Delaware County (918) 787-2020
JOHN R SMITHSON JR. MD
Neurological Surgery
1120 NEO LOOP
GROVE, OK 74344
Delaware County (918) 786-9568

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand Lake Optical, LLC's NPI number?

The NPI number for Grand Lake Optical, LLC is 1649383191. It was assigned to this organization in the NPPES registry on August 17, 2006.

Where is Grand Lake Optical, LLC located?

Grand Lake Optical, LLC is located at 1120 Neo Loop, Grove, OK 74344. The listed phone number is (918) 787-2121.

What is Grand Lake Optical, LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Grand Lake Optical, LLC was last updated on November 18, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.