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Contact Information

ANDERSON PROFESSIONAL EYECARE LLC
412 US HIGHWAY 80 SW
POOLER, GA31322-2541
 Phone: 912-748-3937
 Fax: 912-748-6758
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for ANDERSON PROFESSIONAL EYECARE LLC

NPI # 1982817730
LBN Legal business name ANDERSON PROFESSIONAL EYECARE LLC
Authorized official BENJAMIN ANDERSON - (OWNER LICENSED DISPENSING OPTICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 05/08/2007
Last updated 05/25/2010 - About 16 years ago
Identifiers
GA License # 1696
GA Medicaid 670525139A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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