Provider Demographics
NPI:1114043197
Name:OPTOMETRY UNLIMITED, LLC
Entity Type:Organization
Organization Name:OPTOMETRY UNLIMITED, LLC
Other - Org Name:CHEATHAM COUNTY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TAX MATTERS MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHALMERS
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:HYATT
Authorized Official - Suffix:III
Authorized Official - Credentials:OD
Authorized Official - Phone:615-331-8688
Mailing Address - Street 1:5429 EDMONDSON PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-331-8688
Mailing Address - Fax:615-457-8964
Practice Address - Street 1:154 HUTTON PL
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-4953
Practice Address - Country:US
Practice Address - Phone:615-792-4321
Practice Address - Fax:615-792-6147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3944251Medicare PIN
TN4494830001Medicare NSC