Provider Demographics
NPI:1396913257
Name:FAMILY VISION CARE, LLC
Entity type:Organization
Organization Name:FAMILY VISION CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HORNSBY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:334-684-6070
Mailing Address - Street 1:607 S COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:AL
Mailing Address - Zip Code:36340-2410
Mailing Address - Country:US
Mailing Address - Phone:334-684-6070
Mailing Address - Fax:334-684-2640
Practice Address - Street 1:607 S COMMERCE ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:AL
Practice Address - Zip Code:36340-2410
Practice Address - Country:US
Practice Address - Phone:334-684-6070
Practice Address - Fax:334-684-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332H00000X
ALS584TA252152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALOP2871OtherEYEMED
29447OtherSPECTERA
AL59886OtherDAVIS VISION
AL103169Medicaid
132755OtherVISION CARE PLAN
AL000058183Medicaid
AL51040254OtherBCBS OF AL
AL51040254OtherBCBS OF AL
132755OtherVISION CARE PLAN
ALT68943Medicare UPIN
AL000058183Medicaid
410010622Medicare PIN
AL510G700274Medicare PIN