Provider Demographics
NPI:1386819548
Name:LANIER COLEY EYECARE, INC.
Entity Type:Organization
Organization Name:LANIER COLEY EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:F
Authorized Official - Last Name:COLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:770-536-7222
Mailing Address - Street 1:3446 WINDER HWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-3007
Mailing Address - Country:US
Mailing Address - Phone:770-536-7222
Mailing Address - Fax:770-536-1070
Practice Address - Street 1:3446 WINDER HWY
Practice Address - Street 2:SUITE E
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-3007
Practice Address - Country:US
Practice Address - Phone:770-536-7222
Practice Address - Fax:770-536-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALDO001555332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies