| NPI | 1477591840 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ANNA PURCELL Provider Network Administrator 770-822-4245 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) | 
| Enumeration Date | 2006-06-04 | 
| Last Update Date | 2020-08-22 |