Pulliam Optical

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PULLIAM OPTICAL

Practice address

4167 Hospital Drive
Covington, GA 30014-0469

Phone

(770) 787-7000

Fax

(770) 385-0813

NPI assigned

Apr 4, 2007

Last updated

Apr 21, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Elaine H Pulliam, LDO

Title

Owner

Phone

(770) 787-7000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1245352095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4167 HOSPITAL DR NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142565",
            "telephone_number": "770-787-7000",
            "fax_number": "770-385-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4167 HOSPITAL DRIVE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300140469",
            "telephone_number": "770-787-7000",
            "fax_number": "770-385-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULLIAM OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "PULLIAM",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-787-7000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Covington, GA
• Providers in Covington, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.