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Organization

NASSAR ENTERPRISES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENISE ALEXANDER (MANAGER)
(404) 766-6268
Entity
Organization

Contact information

Practice address
777 CLEVELAND AVE SW STE 616, ATLANTA, GA 30315-7116
(404) 766-6268
Mailing address
6524 PROFESSIONAL PL, RIVERDALE, GA 30274-2520
(770) 996-2096

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
54428
GA
332H00000X
Eyewear Supplier
Primary
54428
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6111490001
DMERC
GA
Enumeration date
09/26/2013
Last updated
09/26/2013
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