Provider Demographics
NPI:1821770454
Name:FAMILY EYE CARE OF GEORGIA, LLC
Entity Type:Organization
Organization Name:FAMILY EYE CARE OF GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:912-489-6655
Mailing Address - Street 1:23993 US HWY 80 EAST
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30461
Mailing Address - Country:US
Mailing Address - Phone:912-489-6655
Mailing Address - Fax:
Practice Address - Street 1:23993 US HWY 80 EAST
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30461
Practice Address - Country:US
Practice Address - Phone:912-489-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty