Boski R. Amin OD, LLC
Organization Active NPI Eyewear Supplier · Lilburn, GA
NPI 1467709246 · NPPES record last updated May 11, 2018
Key facts
- NPI
- 1467709246
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Eyewear Supplier 332H00000X
- License
- OPT002655 (GA)
- Legal business name
- BOSKI R. AMIN OD, LLC
- Practice address
- 4574 Lawrenceville Hwy NW Ste 201
Lilburn, GA 30047-3605 - Phone
- (770) 381-6706
- Fax
- (770) 921-7653
- NPI assigned
- Aug 10, 2012
- Organization subpart
- No
Authorized official
- Name
- Boski R. Amin, O.D
- Title
- Owner
- Phone
- (352) 258-3937
Practitioners 2
-
Boski Rohitkumar Amin, O.D.
-
Jennifer Yin, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121101000411 | GA | Part B Supplier - Clinic/Group Practice | 9032369897 |
Receives reassigned benefits from 2 practitioners Practice locations: Lilburn, GA |
National Provider Directory
Locations
4574 Lawrenceville Hwy NW
Ste 201
Lilburn, GA 30047
Phone (770) 381-6706
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | OPT002655 | GA | Yes |
Addresses
Primary practice location
4574 Lawrenceville Hwy NW Ste 201
Lilburn, GA 30047-3605
Mailing address
4574 Lawrenceville Hwy NW Ste 201
Lilburn, GA 30047-3605
Phone (770) 381-6706
Other names
- Lilburn Family Eye Care
Other providers in Lilburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2018. 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.