Provider Demographics
NPI:1578756631
Name:APPALACHIAN EYE CARE
Entity Type:Organization
Organization Name:APPALACHIAN EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:304-425-2444
Mailing Address - Street 1:700 OAKVALE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-3915
Mailing Address - Country:US
Mailing Address - Phone:304-425-2444
Mailing Address - Fax:304-425-2446
Practice Address - Street 1:700 OAKVALE RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-3915
Practice Address - Country:US
Practice Address - Phone:304-425-2444
Practice Address - Fax:304-425-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV973D152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U83976Medicare UPIN