Provider Demographics
NPI:1023421096
Name:BEST EYECARE OPTICAL, INC.
Entity type:Organization
Organization Name:BEST EYECARE OPTICAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHOON
Authorized Official - Middle Name:K
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:678-473-0911
Mailing Address - Street 1:3751 SATELLITE BLVD
Mailing Address - Street 2:SUITE 200.
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8840
Mailing Address - Country:US
Mailing Address - Phone:678-473-0911
Mailing Address - Fax:678-473-9100
Practice Address - Street 1:3751 SATELLITE BLVD
Practice Address - Street 2:SUITE 200.
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8840
Practice Address - Country:US
Practice Address - Phone:678-473-0911
Practice Address - Fax:678-473-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-08
Last Update Date:2014-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========Medicare Oscar/Certification
GA=========Medicare UPIN