Decatur Optical Dispensary

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

332H00000X Issued in AL

Legal business name

DECATUR OPTICAL DISPENSARY

Practice address

201 6TH Ave SE
Decatur, AL 35601-3115

Phone

(256) 351-0040

Fax

(256) 301-0449

NPI assigned

Oct 5, 2007

Last updated

Sep 3, 2015By 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

Mr. Jack L Holbert

Title

Pres. of Company/Optician

Phone

(256) 351-0040

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1518155381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 6TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013115",
            "telephone_number": "256-351-0040",
            "fax_number": "256-301-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 6TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013115",
            "telephone_number": "256-351-0040",
            "fax_number": "256-301-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR OPTICAL DISPENSARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "HOLBERT",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRES. OF COMPANY/OPTICIAN",
        "authorized_official_telephone_number": "256-351-0040",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "AL",
            "license": "332H00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629014469",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Decatur Morgan Specialists
• Decatur Morgan Women's Center
• Decatur Morgan Wound Care Center
• Decatur Neurology, PC
• Decatur OB GYN Physicians, PC
• Decatur Optical Dispensary
• Decatur Orthopaedic Clinic, LLC
• Decatur Orthopaedics Specialists, P.C.
• Decatur Physicians for Women, P.C.
• Decatur SNF Operations LLC (Decatur Rehabilitation and Healthcare Center)

• Eyewear Supplier in Decatur, AL
• Providers in Decatur, AL by specialty
• Eyewear Supplier in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.