Provider Demographics
NPI:1912379579
Name:SCHAEFFER EYE CENTER, INC.
Entity Type:Organization
Organization Name:SCHAEFFER EYE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-979-2020
Mailing Address - Street 1:P.O. BOX 1310
Mailing Address - Street 2:SCHAEFFER EYE CENTER
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1376
Mailing Address - Country:US
Mailing Address - Phone:205-824-7171
Mailing Address - Fax:205-824-7179
Practice Address - Street 1:445 PROVIDENCE MAIN ST. N.W. SUITE 102
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806
Practice Address - Country:US
Practice Address - Phone:256-722-5425
Practice Address - Fax:256-722-5426
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCHAEFFER EYE CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty