Provider Demographics
NPI:1811038086
Name:CRITTENDEN, INC
Entity Type:Organization
Organization Name:CRITTENDEN, INC
Other - Org Name:EYEAR OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GENIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DURHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-472-0426
Mailing Address - Street 1:2733 KEITH ST NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3706
Mailing Address - Country:US
Mailing Address - Phone:423-472-0426
Mailing Address - Fax:423-559-0129
Practice Address - Street 1:2733 KEITH ST NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3706
Practice Address - Country:US
Practice Address - Phone:423-472-0426
Practice Address - Fax:423-559-0129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN958332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0618670001Medicare ID - Type Unspecified