BROOKHAVEN OPTICAL INC (NPI# 1821080250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821080250 |
| Entity Type | Organization |
| Organization Name | BROOKHAVEN OPTICAL INC |
| Other Organization Name | OPTICAL OUTLET |
| Practice Address |
347 W Cherokee St Brookhaven MS 39601-3219 |
| Practice Telephone | 6018331958 |
| Practice Fax Number | 6018333938 |
| Mailing Telephone | 6018331958 |
| Mailing Fax Number | 6018333938 |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. NATLIE BROWN HERNDON (PRESIDENT) |
| Authorized Official Telephone | 6018331958 |
| Authorized Official Credential | M.S., PH.D. |
| 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 |
|---|---|---|---|
| MS | 00089220 | 05 |
| Other Name | Type Code |
|---|---|
| Optical Outlet | Doing Business As Name - Organization |
| Street Address |
347 W CHEROKEE ST |
| City | BROOKHAVEN |
| State | MS |
| Zip Code | 39601-3219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518037175 | Caleb W. Herndon, M.d., Ph.d., P.a. | Specialist | 347 W Cherokee St, Brookhaven, MS 39601-3219 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329633 | Mary Lindsey Lumley | Nurse Practitioner | 620 Hwy 51, Brookhaven, MS 39601 | 2020-09-01 |
| 1306371687 | Rocky Mountain Holdings, LLC | Ambulance | 411 Highway 51 N, Brookhaven, MS 39601 | 2017-04-25 |
| 1043759269 | Candace C Turner | Counselor | 860 E River Pl Suite 100, Jackson, MS 39601 | 2017-02-21 |
| 1619419694 | Therapy Nook PC | Speech-Language Pathologist | 520 Schwem Avenue, Brookhaven, MS 39601 | 2016-11-08 |
| 1851742639 | Melanie Smith | Specialist/Technologist | 325 Low Water Lane, Brookhaven, MS 39601 | 2016-06-23 |
| 1134597107 | Passionate Care Home Health,llc | Home Health | 537 St Charles Places, Brookhaven, MS 39601 | 2015-09-09 |
| 1205218690 | Nurse Practitioner Professionals, Pllc | Clinic/Center | 427 Highway 51 Se, Kings Daughters Medical Center-wound Healing Center, Brookhaven, MS 39601 | 2015-06-23 |
| 1043639289 | Joseph S Moak Jr Md Pa | Internal Medicine | 1040 Biglane Drive, Brookhaven, MS 39601 | 2014-04-15 |
| 1902239197 | Melanie Hammill Bishop | Pharmacist | 427 Ms Highway 51 North, Brookhaven, MS 39601 | 2013-08-12 |
| 1386930113 | Hospice Advantage, LLC. | Hospice Care, Community Based | 120 W Cherokee St, Brookhaven, MS 39601 | 2011-06-20 |
| Find all providers in zip 39601 | ||||
| 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 |
|---|---|---|---|---|
| 1457746398 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 500 Brookhaven Ave Ne, Brookhaven, GA 30319-3291 | 2015-03-30 |
| 1760490494 | Brookhaven Family Eye Care Center | Eyewear Supplier (Equipment, not the service) | 4106 Edgmont Ave, Brookhaven, PA 19015-2314 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1265072292 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 700 Highland Colony Pkwy, Ridgeland, MS 39157-8701 | 2020-01-07 |
| 1811364698 | Precision Optical Dispensary, Inc | Eyewear Supplier (Equipment, not the service) | 4339 Lakeland Dr, Flowood, MS 39232-8947 | 2015-08-27 |
| 1427433200 | Mississippi Eyecare Associates of Byram, Pllc. | Eyewear Supplier (Equipment, not the service) | 7118b S Siwell Rd, Byram, MS 39272-8744 | 2015-07-22 |
| 1114325164 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 6351 I 55 N, Suite 115-a, Jackson, MS 39213-9720 | 2014-12-08 |
| 1033517016 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 15218a Crossroads Pkwy, Gulfport, MS 39503-3564 | 2014-12-08 |
| 1275960445 | Dr. Mark Lynn & Associates, Pllc | Eyewear Supplier (Equipment, not the service) | 338 Goodman Rd W, Southhaven, MS 38671-9522 | 2013-10-03 |
| 1013256411 | Mississippi Eyecare Associates of Pearl, Pllc | Eyewear Supplier (Equipment, not the service) | 404 Riverwind Dr, Ste B1, Pearl, MS 39208-5900 | 2013-02-05 |
| 1760736409 | Finishing Edge Inc | Eyewear Supplier (Equipment, not the service) | 216 Joe Dear Rd, Harrisville, MS 39082-4024 | 2012-11-02 |
| 1245505825 | Mississippi Eye Care of Hazlehurst | Eyewear Supplier (Equipment, not the service) | 28063 Highway 28, Hazlehurst, MS 39083-2240 | 2012-03-15 |
| Find all providers with the same taxonomy | ||||
| City | BROOKHAVEN |
| Zip Code | 39601 |
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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.