NPIMap

Organization Active NPI

Ecsa Optical Company, LLC

  • Durable Medical Equipment & Medical Supplies
  • Palatka, FL
National Provider Identifier
1407608326
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ECSA OPTICAL COMPANY, LLC
Practice address
800 Zeagler Dr Ste 120
Palatka, FL 32177-3827
Phone
(386) 328-8369
Fax
(904) 810-5687
NPI assigned
Apr 3, 2024
Last updated
Apr 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
Candice B Davis
Title
Chief Revenue Cycle Officer
Phone
(916) 990-7590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

800 Zeagler Dr Ste 120
Palatka, FL 32177-3827

Mailing address

800 Zeagler Dr Ste 120
Palatka, FL 32177-3827
Phone (386) 328-8369

National Provider Directory

National Provider Directory
Tax ID family
Ecsa Optical Company LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

800 Zeagler Dr
Ste 120
Palatka, FL 32177
Phone (386) 328-8369

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1407608326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ZEAGLER DR STE 120",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773827",
            "telephone_number": "386-328-8369",
            "fax_number": "904-810-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ZEAGLER DR STE 120",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773827",
            "telephone_number": "386-328-8369",
            "fax_number": "904-810-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECSA OPTICAL COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF REVENUE CYCLE OFFICER",
        "authorized_official_telephone_number": "916-990-7590"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.