Organization
TUSCALOOSA OPTICAL DISPENSARY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DAVID ANDERS (OWNER)
(205) 562-8177
Entity
Organization
Contact information
Practice address
5121 UNIVERSITY BLVD E, TUSCALOOSA, AL 35404-5207
(205) 562-8177
(205) 554-7968
Mailing address
5121 UNIVERSITY BLVD E, TUSCALOOSA, AL 35404-5207
(205) 562-8177
(205) 554-7968
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
3693
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00059308
—
AL
01
—
051059308
BLUE CROSS BLUE SHIELD
AL
Enumeration date
08/29/2006
Last updated
06/02/2010
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