Provider Demographics
NPI:1366472391
Name:ANGELA COTTON, B.C.O. & ASSOC., INC.
Entity Type:Organization
Organization Name:ANGELA COTTON, B.C.O. & ASSOC., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:W
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:404-377-0592
Mailing Address - Street 1:505 MEDLOCK RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1513
Mailing Address - Country:US
Mailing Address - Phone:404-377-0592
Mailing Address - Fax:404-377-0081
Practice Address - Street 1:505 MEDLOCK RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1513
Practice Address - Country:US
Practice Address - Phone:404-377-0592
Practice Address - Fax:404-377-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0169360001Medicare NSC