Wallace Opticians Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

WALLACE OPTICIANS INC

Practice address

3040 Vine St
Lansing, MI 48912

Phone

(517) 332-8628

Fax

(517) 332-5504

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jack E Wallace III

Title

President

Phone

(517) 332-8628

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700960416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 VINE ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "517-332-8628",
            "fax_number": "517-332-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 VINE ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "517-332-8628",
            "fax_number": "517-332-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE OPTICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-332-8628",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900C36325",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sierra Walker
• Stefan Duvaull Walker
• Vanessa Walker, NP
• Zachary Thomas Walker, MD
• Tressa Walkington, PA
• Jared Wallace
• Abigail Waller, LMSW
• Erik James Walley, D.C.
• Michelle Walls
• Melissa Walraven

• Eyewear Supplier in Lansing, MI
• Providers in Lansing, MI by specialty
• Eyewear Supplier in Michigan

• 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.