# ECSA OPTICAL COMPANY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811749724
- **Authorized official:** MS. CANDICE B DAVIS (CHIEF REVENUE CYCLE OFFICER)
- **Authorized official phone:** (916) 990-7590

## Contact information

- **Practice address:** 319 W TOWN PL STE 8, ST AUGUSTINE, FL 32092-3102
- **Practice address phone:** (904) 940-9200
- **Practice address fax:** (904) 810-5687
- **Mailing address:** 319 W TOWN PL STE 8, ST AUGUSTINE, FL 32092-3102
- **Mailing address phone:** (904) 940-9200
- **Mailing address fax:** (904) 810-5687

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 04/03/2024
- **Last updated:** 04/03/2024