MRS. CAROLE F MEDOU (NPI# 1427667302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427667302 |
Entity Type | Individual |
Full Name | MRS. CAROLE F MEDOU |
Credential | LDO |
Practice Address |
57 Hurricane Shoals Rd Nw Ste A Lawrenceville GA 30046-5396 |
Mailing Address |
1475 Buford Dr Lawrenceville GA 30043-3719 |
Practice Telephone | 6788783540 |
Mailing Telephone | 4705358540 |
Enumeration Date | 2020-07-28 |
Last Update Date | 2020-07-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
2211 | GA | Eye and Vision Services Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | PEACHSTATE, WELLCARE, MEDICAID, CARESOURCE | 752180024 | 01 |
Street Address |
57 HURRICANE SHOALS RD NW STE A |
City | LAWRENCEVILLE |
State | GA |
Zip Code | 30046-5396 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063023174 | Alpha & Omega Hearing Centers | Hearing Instrument Specialist | Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 | 2020-08-12 |
1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
Find all providers in zip 30046 |
Taxonomy Code | 156FX1800X |
Grouping | Eye and Vision Services Providers |
Classification | Technician/Technologist |
Specialization | Optician |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336450485 | National Vision, Inc. | Technician/Technologist | 296 Grayson Hwy, Lawrenceville, GA 30046-5737 | 2010-06-23 |
1740526912 | America's Best Contacts & Eyeglasses | Technician/Technologist | 296 Grayson Hwy, Lawrenceville, GA 30046-5737 | 2012-12-17 |
1497937478 | Lawrenceville Opticians Inc. | Technician/Technologist | 3100 Princeton Pike, Bldg 1 Suite 2f, Lawrenceville, NJ 08648-2300 | 2007-11-30 |
1679799332 | James Thomas Murray | Technician/Technologist | 3100 Princeton Pike, Lawrenceville, NJ 08648-2300 | 2007-04-18 |
1487737631 | Wal-mart Stores East, Lp | Technician/Technologist | 1400 Lawrenceville Hwy, Lawrenceville, GA 30044-2029 | 2006-10-23 |
1073626149 | Total Vision, LLC | Technician/Technologist | 875 Lawrenceville Suwanee Rd, #560, Lawrenceville, GA 30043-8479 | 2006-08-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255966206 | Steven W Burton | Technician/Technologist | 2498 Wingfield Dr, Austell, GA 30106-1762 | 2020-03-10 |
1477185205 | Dale A Klauss | Technician/Technologist | 294 Kenwood Rd Ste A, Fayetteville, GA 30214-3451 | 2020-02-10 |
1104380682 | National Vision Inc | Technician/Technologist | 97 Parkway Dr, Fort Oglethorpe, GA 30742-4249 | 2019-01-29 |
1134683600 | National Vision Inc | Technician/Technologist | 3159 Highway 278 Ne, Covington, GA 30014-2301 | 2019-01-29 |
1255818993 | Kerryn Castellon | Technician/Technologist | 55 Sudderth St, Buford, GA 30518-3335 | 2018-07-25 |
1770075731 | National Vision, Inc. | Technician/Technologist | 916 Loganville Hwy Ste 300, Bethlehem, GA 30620-2145 | 2018-06-05 |
1598262487 | National Vision, Inc. | Technician/Technologist | 534 Marketplace Pkwy Ste 740, Dawsonville, GA 30534-7549 | 2018-04-09 |
1720582992 | Amos D Washington | Technician/Technologist | 10269 Industrial Blvd Ne, Covington, GA 30014-1485 | 2018-03-21 |
1619490489 | Lisa Stonebraker | Technician/Technologist | 105 E Main St Ste 116, Woodstock, GA 30188-5013 | 2017-07-24 |
1063934461 | National Vision, Inc. | Technician/Technologist | 1424 N Expressway Ste 120, Griffin, GA 30223-1753 | 2017-07-07 |
Find all providers with the same taxonomy |
City | LAWRENCEVILLE |
Zip Code | 30046 |
Please comment or provide details below to improve the information on MRS. CAROLE F MEDOU.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.