Jacksonville Optical Co. Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

#346 Issued in NC

Legal business name

JACKSONVILLE OPTICAL CO. INC.

Practice address

353 Western Blvd
Jacksonville, NC 28546-6347

Phone

(910) 353-3827

Fax

(919) 353-0431

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary Franklin Butler, LICENSED OPTICIAN

Title

President

Phone

(910) 353-3827

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1669538534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466347",
            "telephone_number": "910-353-3827",
            "fax_number": "919-353-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466347",
            "telephone_number": "910-353-3827",
            "fax_number": "919-353-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE OPTICAL CO. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-353-3827",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICENSED OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NC",
            "license": "#346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8801908",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Eyewear Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.