Provider Demographics
NPI:1346704806
Name:FAMILY EYE HEALTH CARE CLINIC, P. L. L. C.
Entity Type:Organization
Organization Name:FAMILY EYE HEALTH CARE CLINIC, P. L. L. C.
Other - Org Name:FAMILY EYE HEALTH CARE CLINIC, P.L.L.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:O.D.
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHANAN KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-967-6531
Mailing Address - Street 1:3101 E CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-4960
Mailing Address - Country:US
Mailing Address - Phone:304-325-3603
Mailing Address - Fax:304-325-3605
Practice Address - Street 1:3101 E CUMBERLAND RD
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-4960
Practice Address - Country:US
Practice Address - Phone:304-325-3603
Practice Address - Fax:304-325-3605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty