Robertson Optical Laboratories Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

352 Issued in SC

Legal business name

ROBERTSON OPTICAL LABORATORIES INC

Practice address

1812 Washington Street
Columbia, SC 29201

Phone

(803) 254-9381

Fax

(803) 254-1978

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gordon Quattlebaum Scott Jr., SC OPTICIANNPI 1447387048

Title

Vice President-Owner

Phone

(803) 254-9381

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Gordon Quatlebaum Scott Jr., OPTICIAN

  • Optician
  • Columbia, SC
  • NPI 1447387048
  NPD (past) Authorized official

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851430839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 WASHINGTON STREET",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-254-9381",
            "fax_number": "803-254-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 WASHINGTON STREET",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-254-9381",
            "fax_number": "803-254-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTSON OPTICAL LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "QUATTLEBAUM",
        "authorized_official_title_or_position": "VICE PRESIDENT-OWNER",
        "authorized_official_telephone_number": "803-254-9381",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "SC OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "SC",
            "license": "352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DVO105",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VA9999",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Roberts, CNM
• Princilla Marie Roberts, FNP
• Rebekah Lilah Roberts, RN
• Sherman Leon Roberts Jr., PT, DPT
• Tamia Roberts
• Catherine Rose Robertson, PH.D.
• Pamela B. Robertson, RPH
• Rashanda Robertson, PHARMD
• Anastasia Lauren Robey, R.N.
• Michael J Robichaud, P.A.

• Eyewear Supplier in Columbia, SC
• Providers in Columbia, SC by specialty
• Eyewear Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.