Provider Demographics
NPI:1033632682
Name:WEST TENNESSEE EYE CARE, PC
Entity Type:Organization
Organization Name:WEST TENNESSEE EYE CARE, PC
Other - Org Name:EYERX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANTLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:615-301-5894
Mailing Address - Street 1:2204 CRESTMOOR RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2002
Mailing Address - Country:US
Mailing Address - Phone:615-301-5894
Mailing Address - Fax:615-712-9371
Practice Address - Street 1:2204 CRESTMOOR RD STE 200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2002
Practice Address - Country:US
Practice Address - Phone:615-301-5894
Practice Address - Fax:615-712-9371
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST TENNESSEE EYE CARE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy