Provider Demographics
NPI:1134241672
Name:THE SAUN CORPORATION
Entity type:Organization
Organization Name:THE SAUN CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:404-626-7219
Mailing Address - Street 1:4690 JEFFERSON TOWNSHIP LN
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-5000
Mailing Address - Country:US
Mailing Address - Phone:404-402-7870
Mailing Address - Fax:770-872-7463
Practice Address - Street 1:4690 JEFFERSON TOWNSHIP LN
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-5000
Practice Address - Country:US
Practice Address - Phone:404-402-7870
Practice Address - Fax:770-872-7463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1027152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP8028Medicare PIN
GAU06335Medicare UPIN
GA6231180001Medicare NSC