Deridder Optical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DERIDDER OPTICAL LLC

Practice address

1509 N Pine St Ste a
Deridder, LA 70634-2417

Phone

(337) 463-9821

Fax

(337) 463-9821

NPI assigned

Jan 16, 2024

Organization subpart

No

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

Authorized official

Name

Debra Inez WelchNPI 1619099231

Title

Optician

Phone

(337) 463-9821

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debra Inez Welch, A.B.O.C. AMERICAN BO

  • Optician
  • Deridder, LA
  • NPI 1619099231
  NPD Authorized official

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1932960192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 N PINE ST STE A",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342417",
            "telephone_number": "337-463-9821",
            "fax_number": "337-463-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 N PINE ST STE A",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342417",
            "telephone_number": "337-463-9821",
            "fax_number": "337-463-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERIDDER OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "INEZ",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "337-463-9821"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Deridder, LA
• Providers in Deridder, LA by specialty
• Durable Medical Equipment & Medical Supplies in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.