Healthcare Provider Details

I. General information

NPI: 1831155332
Provider Name (Legal Business Name): PRESCRIPTION EYEWEAR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8131 SEATON PL
MONTGOMERY AL
36116-7205
US

IV. Provider business mailing address

8131 SEATON PL
MONTGOMERY AL
36116-7205
US

V. Phone/Fax

Practice location:
  • Phone: 334-323-1893
  • Fax: 334-323-1895
Mailing address:
  • Phone: 334-323-1893
  • Fax: 334-323-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. OLIVER O FAULKNER
Title or Position: MANAGING EMPLOYEE
Credential:
Phone: 334-271-4664