Provider Demographics
NPI:1295867448
Name:OPTICAL CONCEPTS, INC.
Entity Type:Organization
Organization Name:OPTICAL CONCEPTS, INC.
Other - Org Name:PARADISE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-977-1222
Mailing Address - Street 1:2745 SANDY PLAINS RD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-4327
Mailing Address - Country:US
Mailing Address - Phone:770-977-1222
Mailing Address - Fax:770-973-2382
Practice Address - Street 1:2745 SANDY PLAINS RD
Practice Address - Street 2:SUITE 132
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-4327
Practice Address - Country:US
Practice Address - Phone:770-977-1222
Practice Address - Fax:770-973-2382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1017332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier