Andrea J. Washington O.D. PC
Organization Active NPI Optometrist · Covington, GA
NPI 1316129463 · NPPES record last updated Oct 11, 2019
Key facts
- NPI
- 1316129463
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- ANDREA J. WASHINGTON O.D. PC
- Practice address
- 4106 Mill St NE Ste a
Covington, GA 30014-2539 - Phone
- (678) 625-3937
- Fax
- (770) 786-8216
- NPI assigned
- Nov 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Andrea J Washington, O.D.
- Title
- Owner/Optometrist
- Phone
- (678) 682-5524
Practitioners 2
-
Andrea Washington, O.D.
-
Amos D Washington, LDO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071128000444 | GA | Part B Supplier - Clinic/Group Practice | 3072602069 |
Receives reassigned benefits from 1 practitioner Practice locations: Covington, GA |
National Provider Directory
Locations
4106 Mill St NE
#A
Covington, GA 30014
Phone (678) 625-3937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes | ||
| Vision Therapy Optometrist |
152WV0400X |
Addresses
Primary practice location
4106 Mill St NE Ste a
Covington, GA 30014-2539
Mailing address
PO Box 1506
Covington, GA 30015-1506
Phone (678) 682-5524
Other providers in Covington, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.