Organization
ATLANTA EYE PROSTHETICS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO LOUIS ALCORTA I BCO (PRESIDENT)
(559) 940-1189
Entity
Organization
Contact information
Practice address
6065 ROSWELL RD STE 870, SANDY SPRINGS, GA 30328-4065
(404) 352-4550
(404) 352-5833
Mailing address
6065 ROSWELL RD STE 870, SANDY SPRINGS, GA 30328-4065
(404) 352-4550
(404) 352-5833
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
119660-8
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000411166A
—
GA
01
—
0758420001
MEDICARE SUPPLIER BILLING NUMBER
GA
Enumeration date
11/06/2006
Last updated
09/06/2023
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