1982803136 NPI number — SCHAEFFER EYE CENTER INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982803136 NPI number — SCHAEFFER EYE CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCHAEFFER EYE CENTER INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982803136
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TRUSSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35173-6102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-661-2080
Provider Business Mailing Address Fax Number:
205-661-2085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3431 COLONNADE PKWY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35243-3232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-967-2020
Provider Business Practice Location Address Fax Number:
205-967-7120
Provider Enumeration Date:
07/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HELMS
Authorized Official First Name:
GLENDA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING COORDINATOR
Authorized Official Telephone Number:
205-661-2020

Provider Taxonomy Codes

  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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