DECATUR OPTICAL DISPENSARY (NPI# 1629014469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629014469 |
| Entity Type | Organization |
| Organization Name | DECATUR OPTICAL DISPENSARY |
| Practice Address |
201 6th Ave Se Decatur AL 35601-3115 |
| Practice Telephone | 2563510040 |
| Practice Fax Number | 2563019449 |
| Mailing Telephone | 2563510040 |
| Mailing Fax Number | 2563019449 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2015-01-14 |
| Authorized Official Name | MR. JACK LYNN HOLBERT (PRESIDENT) |
| Authorized Official Telephone | 2563510040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 000059076 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518155381 | Decatur Optical Dispensary | Eyewear Supplier (Equipment, not the service) | 201 6th Ave Se, Decatur, AL 35601-3115 | 2007-10-05 |
| Street Address |
201 6TH AVE SE |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-3115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255386637 | Douglas L Mann IIi | Optometrist | 201 6th Ave Se, Decatur, AL 35601-3115 | 2006-05-23 |
| 1023286192 | Dr. Douglas L. Mann IIi PC | Optometrist | 201 6th Ave Se, Decatur, AL 35601-3115 | 2008-02-12 |
| 1518155381 | Decatur Optical Dispensary | Eyewear Supplier (Equipment, not the service) | 201 6th Ave Se, Decatur, AL 35601-3115 | 2007-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609924109 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 1801 Beltline Rd Sw, Colonial Mall, Decatur, AL 35601-5501 | 2007-01-08 |
| 1366497158 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 2800 Spring Ave Sw, Decatur, AL 35603-1218 | 2006-05-23 |
| 1265688816 | R W Baron Inc | Eyewear Supplier (Equipment, not the service) | 710 S 13th St, Decatur, IN 46733-1802 | 2008-08-14 |
| 1932379849 | John C Lee Md Sc | Eyewear Supplier (Equipment, not the service) | 1714 S Blaine Ln, Decatur, IL 62521-5025 | 2008-03-06 |
| 1710156773 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 3580 Memorial Dr, Decatur, GA 30032-2713 | 2008-02-25 |
| 1912188996 | Optiworld Vision Center, LLC | Eyewear Supplier (Equipment, not the service) | 2801 Candler Rd, Suite 66, Decatur, GA 30034-1423 | 2007-11-19 |
| 1518155381 | Decatur Optical Dispensary | Eyewear Supplier (Equipment, not the service) | 201 6th Ave Se, Decatur, AL 35601-3115 | 2007-10-05 |
| 1831381300 | Patty C Landers | Eyewear Supplier (Equipment, not the service) | 2620 Centron Dr Sw, Decatur, AL 35603-2500 | 2007-08-17 |
| 1942346101 | Marx Optical Inc | Eyewear Supplier (Equipment, not the service) | 2620 Centron Dr Sw, Decatur, AL 35603-2500 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043834492 | Ajs Industries Inc | Eyewear Supplier (Equipment, not the service) | 3922 Us Highway 80 W Ste A, Phenix City, AL 36870-6514 | 2020-06-02 |
| 1699249672 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1627 Opelika Rd, Auburn, AL 36830-2871 | 2019-01-14 |
| 1174011209 | Pinnacle Optical, LLC | Eyewear Supplier (Equipment, not the service) | 1900 Crestwood Blvd Ste 100, Irondale, AL 35210-2056 | 2018-04-24 |
| 1598282816 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1821 2nd Ave N, Birmingham, AL 35203-3156 | 2017-08-28 |
| 1972059814 | Southeast Vision LLC | Eyewear Supplier (Equipment, not the service) | 106 West Veterans Drive, Auburn, AL 36832 | 2016-08-31 |
| 1427504760 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 50 Commons Way, Suite D, Oxford, AL 36203 | 2016-08-28 |
| 1679026090 | Eyeglasses Services On Wheels | Eyewear Supplier (Equipment, not the service) | 101 Old Hackberry Ln, 1209, Tuscaloosa, AL 35401-7460 | 2016-08-02 |
| 1295128189 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1450 Tingle Circle West, Mobile, AL 36606 | 2015-03-17 |
| 1477943041 | Invision Optical Inc. | Eyewear Supplier (Equipment, not the service) | 350 Hallman Hl E, Suite 81, Homewood, AL 35209-6532 | 2015-02-03 |
| 1720410905 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 2601 S Mckenzie St Spc 234, #234, Foley, AL 36535-3488 | 2013-07-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.