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General NPI Number Information
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NPI Number | 1174011209
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Entity Type | Organization
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Legal Business Name | PINNACLE OPTICAL, LLC
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 1900 CRESTWOOD BLVD STE 100
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City | IRONDALE
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State | AL
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Zip | 35210-2056
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Country | US
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Telephone | 205-542-0541
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Fax | 205-278-8770
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Provider Business Mailing Address
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Address Line | 1900 CRESTWOOD BLVD STE 100
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City | IRONDALE
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State | AL
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Zip | 35210-2056
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Country | US
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Telephone | 205-542-0541
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Fax | 205-278-8770
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JAMES GREGORY BLACKWELL
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Credential |
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Telephone | 205-542-0541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State | AL
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