Healthcare Provider Details

I. General information

NPI: 1356409643
Provider Name (Legal Business Name): BUTLER OPTICAL CENTER,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 NORTH MULBERRY
BUTLER AL
36904-2224
US

IV. Provider business mailing address

130 NORTH MULBERRY
BUTLER AL
36904-2224
US

V. Phone/Fax

Practice location:
  • Phone: 205-459-2460
  • Fax: 205-453-2462
Mailing address:
  • Phone: 205-459-2460
  • Fax: 205-453-2462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHY LYNN CORNETT
Title or Position: MANAGER
Credential:
Phone: 205-459-2460