Active NPI
Custom Ocular Prosthetics, Inc.
- Prosthetic/Orthotic Supplier
- Tucson, AZ
National Provider Identifier
1407047319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- NOT REQUIRED BY STAT
- Legal business name
- CUSTOM OCULAR PROSTHETICS, INC.
- Practice address
- 9465 E Harrison PL
Tucson, AZ 85710-6613 - Phone
- (520) 722-7471
- NPI assigned
- Aug 6, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. James R. Ward, OCULARIST
- Title
- President
- Phone
- (520) 722-7471
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | NOT REQUIRED BY STAT | AZ | Primary |
Addresses
Primary practice location
9465 E Harrison PL
Tucson, AZ 85710-6613
Mailing address
9465 E Harrison PL
Tucson, AZ 85710-6613
Phone (520) 722-7471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 309543 | Medicaid | AZ |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1203379200000",
"number": "1407047319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9465 E HARRISON PL",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857106613",
"telephone_number": "520-722-7471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9465 E HARRISON PL",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857106613",
"telephone_number": "520-722-7471"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CUSTOM OCULAR PROSTHETICS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-06",
"last_updated": "2008-02-19",
"status": "A",
"authorized_official_last_name": "WARD",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "R.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "520-722-7471",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "OCULARIST"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "AZ",
"license": "NOT REQUIRED BY STAT",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "309543",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.