Organization Active NPI

Eyemart Express, LTD.

  • Durable Medical Equipment & Medical Supplies
  • Ashwaubenon, WI
National Provider Identifier
1700929460
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
EYEMART EXPRESS, LTD.
Practice address
2811 S Oneida St
Ashwaubenon, WI 54304-5748
Phone
(920) 496-0012
Fax
(920) 496-0256
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2811 S Oneida St
Ashwaubenon, WI 54304-5748

Mailing address

2110 Hutton Dr
Suite 100
Carrollton, TX 75006-6800

National Provider Directory

National Provider Directory

NPI Registry JSON

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": "1700929460",
    "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": "2811 S ONEIDA ST",
            "city": "ASHWAUBENON",
            "state": "WI",
            "postal_code": "543045748",
            "telephone_number": "920-496-0012",
            "fax_number": "920-496-0256"
        }
    ],
    "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashwaubenon, WI

Sources for this page

  • 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.