Healthcare Provider Details
I. General information
NPI: 1356762454
Provider Name (Legal Business Name): SARRELL DENTAL AND EYE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/17/2013
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1004 SOUTH ST E
TALLADEGA AL
35160-2621
US
IV. Provider business mailing address
230 E 10TH ST SUITE 106
ANNISTON AL
36207-5784
US
V. Phone/Fax
- Phone: 256-741-7340
- Fax: 256-741-7373
- Phone: 256-741-7340
- Fax: 256-741-7373
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CATHERINE
H
CHAPPELL
Title or Position: OPTICAL MANAGER
Credential:
Phone: 256-741-7340