Provider Demographics
NPI:1457520728
Name:COBB EYE CENTER, LLP
Entity Type:Organization
Organization Name:COBB EYE CENTER, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:UNA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:FELTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-425-1341
Mailing Address - Street 1:130 VANN ST NE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7230
Mailing Address - Country:US
Mailing Address - Phone:770-425-1341
Mailing Address - Fax:770-428-6484
Practice Address - Street 1:1680 MULKEY RD
Practice Address - Street 2:SUITE C
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1118
Practice Address - Country:US
Practice Address - Phone:770-944-0933
Practice Address - Fax:770-944-6456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACB0852OtherMEDICARE RAILROAD
GACB0852OtherMEDICARE RAILROAD
GAGRP1452Medicare PIN