| Organization Name: | EYE SITE OF BUFORD, INC. |
| NPI Number: | 1073505053 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYMOND D RUPURED (C FO) |
| Mailing Address: | 4420 Nelson Brogdon Blvd Buford |
| State: | GA US |
| Postal Code: | 305183477 |
| Phone Number: | 7709329656 |
| Fax Number: | 7709326606 |
| NPI Enumeration Date: | 08/16/2005 |
| NPI Last Update Date: | 06/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | GA1214 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |