Provider Demographics
NPI:1043331754
Name:STEVENS OPTICAL
Entity type:Organization
Organization Name:STEVENS OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:333-426-7777
Mailing Address - Street 1:130 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:EAST PALESTINE
Mailing Address - State:OH
Mailing Address - Zip Code:44413-2019
Mailing Address - Country:US
Mailing Address - Phone:330-426-7777
Mailing Address - Fax:
Practice Address - Street 1:130 N MARKET ST
Practice Address - Street 2:
Practice Address - City:EAST PALESTINE
Practice Address - State:OH
Practice Address - Zip Code:44413-2019
Practice Address - Country:US
Practice Address - Phone:330-426-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSC4580156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty