Provider Demographics
NPI:1578517405
Name:EYECARE PLUS GH PLLC
Entity Type:Organization
Organization Name:EYECARE PLUS GH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHEYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-988-5303
Mailing Address - Street 1:1911 GLEN ECHO RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2805
Mailing Address - Country:US
Mailing Address - Phone:615-298-2669
Mailing Address - Fax:615-298-2775
Practice Address - Street 1:1911 GLEN ECHO RD
Practice Address - Street 2:SUITE B
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2805
Practice Address - Country:US
Practice Address - Phone:615-298-2669
Practice Address - Fax:615-298-2775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3597672Medicare PIN
TN3942102Medicare PIN
TN4871350001Medicare NSC
TN3598364Medicare PIN
TN3722006Medicare ID - Type Unspecified