Southeastern Ocularists, Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

SOUTHEASTERN OCULARISTS, INC.

Practice address

1300 Hospital Dr
Suite 260
Mt Pleasant, SC 29464-3261

Phone

(843) 884-7113

Fax

(704) 510-9881

NPI assigned

Jul 26, 2006

Last updated

Apr 5, 2016By 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. Robert HenderliteNPI 1881619633

Title

President

Phone

(704) 510-9292

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Southeastern Ocularists Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southeastern Ocularists, Inc.

  • Customized Equipment (DME)
  • Charlotte, NC
  • NPI 1033396551
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert L Henderlite

  • Ocularist
  • Charlotte, NC
  • NPI 1881619633
  NPD Authorized official
• Armon S Alcocer Akhlaghi, B.C.O.

  • Ocularist
  • Charlotte, NC
  • NPI 1073460465
  NPD (past)
• Joshua Lee Hrdlick, BCO

  • Ocularist
  • Charlotte, NC
  • NPI 1013892710
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1841213196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8426 MEDICAL PLAZA DR",
            "address_2": "SUITE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629746",
            "telephone_number": "704-510-9292",
            "fax_number": "704-510-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL DR",
            "address_2": "SUITE 260",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643261",
            "telephone_number": "843-884-7113",
            "fax_number": "704-510-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN OCULARISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "HENDERLITE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-510-9292",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2724",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Southeastern Spine Institute,LLC
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• Lucas Drew Southerland, D.C.
• Southern Grace Pain & Regenerative Medicine

• Customized Equipment (DME) in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Customized Equipment (DME) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.