Provider Demographics
NPI:1164178281
Name:FAMILY FIRST VISION CARE KENTUCKY, LLC
Entity Type:Organization
Organization Name:FAMILY FIRST VISION CARE KENTUCKY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:EVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-831-0268
Mailing Address - Street 1:316 S HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3350
Mailing Address - Country:US
Mailing Address - Phone:614-676-0550
Mailing Address - Fax:317-534-3011
Practice Address - Street 1:1717 -117 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1248
Practice Address - Country:US
Practice Address - Phone:205-985-0971
Practice Address - Fax:317-534-3011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty