Provider Demographics
NPI:1285002352
Name:FLORENCE EYE CENTER, INC.
Entity Type:Organization
Organization Name:FLORENCE EYE CENTER, INC.
Other - Org Name:SPECS OF MADISON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-766-3139
Mailing Address - Street 1:21 HUGHES RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3039
Mailing Address - Country:US
Mailing Address - Phone:256-246-2969
Mailing Address - Fax:256-767-7374
Practice Address - Street 1:21 HUGHES RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3039
Practice Address - Country:US
Practice Address - Phone:256-246-2969
Practice Address - Fax:256-767-7374
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORENCE EYE CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-08
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS722TA009152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty