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NPI Code Detail

MEDICARE: RAINBOW CITY FAMILY EYE CARE, LLC

MEDICARE: RAINBOW CITY FAMILY EYE CARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332H00000XEyewear SupplierS-732-TA-108AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912193798
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAINBOW CITY FAMILY EYE CARE, LLC
Provider Business Mailing Address
First Line : 115 W GRAND AVE
Second Line : SUITE 120
City : RAINBOW CITY
State : AL
Zip : 35906-3275
Country : US
Telephone Number : 256-442-9350
Fax Number : 256-442-9352
Provider Business Practice Location Address
First Line : 115 W GRAND AVE
Second Line : SUITE 120
City : RAINBOW CITY
State : AL
Zip : 35906-3275
Country : US
Telephone Number : 256-442-9350
Fax Number : 256-442-9352
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. AMANDA V WALL
Credential :
Telephone Number : 256-442-9350
Provider Enumeration Date : 09/14/2007
Last Update Date : 08/19/2011

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Directions to “RAINBOW CITY FAMILY EYE CARE, LLC ” Practice Location

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