Decatur Optical Dispensary

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

DECATUR OPTICAL DISPENSARY

Practice address

201 6TH Ave SE
Decatur, AL 35601-3115

Phone

(256) 351-0040

Fax

(256) 301-9449

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jack Lynn Holbert

Title

President

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": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1629014469",
    "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": "256-301-9449"
        },
        {
            "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": "256-301-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR OPTICAL DISPENSARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "HOLBERT",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-351-0040",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059076",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 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 Surgery Center LP

• 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 Jan 14, 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.