Tuscaloosa Optical Dispensary, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

3693 Issued in AL

Legal business name

TUSCALOOSA OPTICAL DISPENSARY, INC.

Practice address

5121 University Blvd E
Tuscaloosa, AL 35404-5207

Phone

(205) 562-8177

Fax

(205) 554-7968

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

William David Anders

Title

Owner

Phone

(205) 562-8177

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1609984673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045207",
            "telephone_number": "205-562-8177",
            "fax_number": "205-554-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045207",
            "telephone_number": "205-562-8177",
            "fax_number": "205-554-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSCALOOSA OPTICAL DISPENSARY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "ANDERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-562-8177"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "AL",
            "license": "3693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00059308",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051059308",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.