NPI 1154085306 · live from the CMS NPI Registry
Atl Optical LLC
Eyewear Supplier (Equipment, not the service) in Atlanta, GA. National Provider Identifier 1154085306, active.
NPI record
| NPI | 1154085306 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Eyewear Supplier (Equipment, not the service) 332H00000X |
| Practice location | 1671 Howell Mill Rd Nw, Atlanta, GA 30318 |
| Practice phone | 956-335-6476 |
| Mailing address | 1943 Pleasant Hill Rd, Duluth, GA 30096 |
| Enumerated | October 25, 2021 |
| Last updated | October 25, 2021 |
| Authorized official | Jackie Bennett, Credentialing Supervisor |
| Other names | My Eyelab |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | — |
| Eyewear Supplier (Equipment, not the service) primary | 332H00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.