Healthcare Provider Details

I. General information

NPI: 1992212757
Provider Name (Legal Business Name): FAMILY VISION AND HEARING COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 03/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 N MCKENZIE ST
FOLEY AL
36535-2326
US

IV. Provider business mailing address

PO BOX 371
FOLEY AL
36536-0371
US

V. Phone/Fax

Practice location:
  • Phone: 251-233-3559
  • Fax:
Mailing address:
  • Phone: 251-943-4395
  • Fax: 251-943-4209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: JUN WU
Title or Position: OPTICIAN
Credential:
Phone: 251-943-4395