BLAIRWOOD OPTICAL LLC NPI 1851056865

NPI Information

  • NPI: 1851056865
  • Provider Name: BLAIRWOOD OPTICAL, LLC
  • Classification: Eyewear Supplier - 332H00000X
  • Entity Type: Organization
  • Address: 27184 US HIGHWAY 80 W
    PORTAL, GA
    ZIP 30450
  • Phone: (912) 865-5300

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NPI Details

BLAIRWOOD OPTICAL, LLC is an eyewear supplier in Portal, GA. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. BLAIRWOOD OPTICAL, LLC NPI is 1851056865. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

27184 US HIGHWAY 80 W
PORTAL, GA
ZIP 30450-247
Phone: (912) 865-5300
Fax: (912) 865-5336

The provider's authorized official is Krystal Lynn Penley .
The authorized official title is C0 Owner and has the following contact phone number (912) 865-5300.

The enumeration date for this NPI number is 11/4/2021 and was last updated on 12/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1156FX1800XTechnician/TechnologistOpticianNo
2332H00000XEyewear SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1LDO2341OTHERGEORGIALICENSED DISPENSING OPTICAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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