OPTICAL EXPRESS OF CRYSTAL RIVER INC
Complete NPI Record 1710148671
Eyewear Supplier in Crystal River, FL

NPI Status: Active since June 23, 2008

Contact Information

1801 NW US HWY 19
SUITE 165
CRYSTAL RIVER, FL
ZIP 34428
Phone: (352) 795-2020
Fax: (352) 795-7432

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Complete NPI Dataset

This directory record outlines the complete schema field listings, logged data values, and structural definitions for OPTICAL EXPRESS OF CRYSTAL RIVER INC (NPI: 1710148671), practicing as a certified eyewear supplier specialist with primary operations located in Crystal River, FL. The dataset listed below details the current information logged inside the National Plan and Provider Enumeration System (NPPES) registry database for this specific individual assignment. Please use the integrated filtering tools directly below to separate properties by functional clinical categories, perform live keyword lookups, or jump immediately to a single tracking attribute line item.

Registry File Document Utilities
NPI: 1710148671
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: OPTICAL EXPRESS OF CRYSTAL RIVER INC
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 1801 NW US HIGHWAY 19
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing Address: SUITE 165
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City Name: CRYSTAL RIVER
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: FL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 344286133
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 3527952020
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 3527957432
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 1801 NW US HWY 19
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: SUITE 165
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CRYSTAL RIVER
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: FL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 344286119
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3527952020
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3527957432
The fax number associated with the location address of the provider being identified.
Authorized Official Last Name: MCFALL FIALKO
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: HILDA
The first name of the authorized official.
Authorized Official Middle Name: ANNE
The middle name of the authorized official.
Authorized Official Title or Position: OPTICIAN OWNER
The title or position of the authorized official.
Authorized Official Telephone Number: 3527952020
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 332H00000X
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Organization Subpart: N
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
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