Provider Demographics
NPI:1598942401
Name:RICHARD C. ORGAIN
Entity Type:Organization
Organization Name:RICHARD C. ORGAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:STEFFY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-824-5486
Mailing Address - Street 1:131 INDIAN LAKE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3866
Mailing Address - Country:US
Mailing Address - Phone:615-824-5486
Mailing Address - Fax:615-824-1770
Practice Address - Street 1:131 INDIAN LAKE ROAD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3886
Practice Address - Country:US
Practice Address - Phone:615-824-5486
Practice Address - Fax:615-824-1770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN0661152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0147850001Medicare NSC