Eyemart Express, LTD.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EYEMART EXPRESS, LTD.

Practice address

4703 16TH St
Suite B
Moline, IL 61265-7066

Phone

(309) 762-6278

Fax

(309) 762-6344

NPI assigned

Feb 14, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Jo Samuelson

Title

Chief Administrarive Officer

Phone

(972) 488-2002

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639212384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 HUTTON DR",
            "address_2": "SUITE 100",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4703 16TH ST",
            "address_2": "SUITE B",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657066",
            "telephone_number": "309-762-6278",
            "fax_number": "309-762-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEMART EXPRESS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAMUELSON",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "CHIEF ADMINISTRARIVE OFFICER",
        "authorized_official_telephone_number": "972-488-2002"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Catherine Mary Farrell, PTA

• Durable Medical Equipment & Medical Supplies in Moline, IL
• Providers in Moline, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.