Provider Demographics
NPI:1154474732
Name:EYEWORLD VISION CENTER, LLC
Entity Type:Organization
Organization Name:EYEWORLD VISION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-645-2991
Mailing Address - Street 1:PO BOX 656
Mailing Address - Street 2:
Mailing Address - City:SEMMES
Mailing Address - State:AL
Mailing Address - Zip Code:36575-0656
Mailing Address - Country:US
Mailing Address - Phone:251-645-2991
Mailing Address - Fax:251-645-0723
Practice Address - Street 1:7930 MOFFETT RD
Practice Address - Street 2:SUITE A
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-5408
Practice Address - Country:US
Practice Address - Phone:251-645-2991
Practice Address - Fax:251-645-0723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty