CUSTOM OPTICAL OF FONDREN LLC
NPI 1467622605
Eyewear Supplier in Jackson, MS

Active since March 04, 2008
661 DULING AVE, JACKSON, MS 39216(601) 362-6675(601) 362-5767 Get Directions Write a Review

NPPES record last updated: April 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Custom Optical Of Fondren Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CUSTOM OPTICAL OF FONDREN LLC (NPI 1467622605) is a healthcare organization registered as an eyewear supplier in Jackson, Mississippi and active in the NPI registry since March 2008. The organization lists Patricia Hammons, Owner/optician, as its authorized official.

NPPES Registry Identity

NPI1467622605
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameCUSTOM OPTICAL OF FONDREN LLC
Location Address661 DULING AVEJackson, MS 39216-4008
Mailing Address661 Duling AveJackson, MS 39216-4008 · (601) 362-6675 · Fax (601) 362-5767
Fax(601) 362-5767
Organization SubpartNo
Authorized OfficialPatricia HammonsOwner/optician · (601) 362-6675
Enumeration DateMarch 4, 2008
Last NPPES UpdateApril 29, 2022
NPPES CertifiedApril 27, 2022
NPI 1467622605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
661 DULING AVE, Jackson, MS 39216

Other Names 1

Other NameCustom Optical Of Fondren Llc

Medical Equipment Supplier Medicare DMEPOS

Medicare supplier enrollment and the product categories Custom Optical Of Fondren LLC carries, from the Medicare DMEPOS supplier directory.

Custom Optical Of Fondren LLC

DMEPOS supplier · Jackson, MS

Does not accept Medicare assignment

Custom Optical Of Fondren LLC has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20350535
Medicare Participant SinceMarch 18, 2022
Supplier Location661 Duling AveJackson, MS 39216
Supplier Specialties
Optician

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Technician/Technologist (Optician)
661 DULING AVE
JACKSON, MS 39216

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Custom Optical Of Fondren LLC's NPI number?

The NPI number for Custom Optical Of Fondren LLC is 1467622605. It was assigned to this organization in the NPPES registry on March 4, 2008.

Where is Custom Optical Of Fondren LLC located?

Custom Optical Of Fondren LLC is located at 661 Duling Ave, Jackson, MS 39216. The listed phone number is (601) 362-6675.

What is Custom Optical Of Fondren LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Does Custom Optical Of Fondren LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Custom Optical Of Fondren LLC does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

When was this NPI record last updated?

The NPPES record for Custom Optical Of Fondren LLC was last updated on April 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.