MEDICARE: ANDERSON PROFESSIONAL EYECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier	1696	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982817730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDERSON PROFESSIONAL EYECARE LLC

Provider Business Mailing Address
First Line	:	412 US HIGHWAY 80 SW
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-2541
Country	:	US
Telephone Number	:	912-748-3937
Fax Number	:	912-748-6758

Provider Business Practice Location Address
First Line	:	412 US HIGHWAY 80 SW
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-2541
Country	:	US
Telephone Number	:	912-748-3937
Fax Number	:	912-748-6758

Authorized Official
Title or Position	:	OWNER LICENSED DISPENSING OPTICIAN
Name	:	MR. BENJAMIN DUNCAN ANDERSON
Credential	:	LDO
Telephone Number	:	912-748-3937

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	05/25/2010

Similar Medicare Providers

1710988472 — DR. DAWN HOSTETLER MACMILLAN AU.D., CCC-A
Practice Location Address:

410 US HIGHWAY 80 SW
POOLER, GA
31322-2541

Practice Phone: 912-748-9494
Practice Fax: 912-748-9495

1497725246 — DR. PRESTON LLOYD PEACOCK DC
Practice Location Address:

408 US HIGHWAY 80 SW
POOLER, GA
31322-2541

Practice Phone: 912-748-0350
Practice Fax: 912-450-0350

1518138940 — COASTAL AUDIOLOGY INC.
Practice Location Address:

410 US HIGHWAY 80 SW
POOLER, GA
31322-2541

Practice Phone: 912-748-9494
Practice Fax: 912-748-9495

1851675441 — KENNETH C. FRIES, O.D., P.C.
Practice Location Address:

412 US HIGHWAY 80 SW
POOLER, GA
31322-2541

Practice Phone: 912-748-3937
Practice Fax: 912-748-6758

1326463993 — ADVANCED CHIROPRACTIC CENTER P.C.
Practice Location Address:

408 US HIGHWAY 80 SW
POOLER, GA
31322-2541

Practice Phone: 912-748-0350
Practice Fax: 912-450-0350

1841602372 — KERRI JO HUDSON AU.D.
Practice Location Address:

410 SW US HIGHWAY 80
POOLER, GA
31322-2541

Practice Phone: 912-748-9494
Practice Fax:

Directions to “ANDERSON PROFESSIONAL EYECARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.