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General NPI Number Information
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NPI Number | 1790871820
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Entity Type | Organization
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Legal Business Name | PAIRS WEST ALABAMA EYECARE
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 2615 MCFARLAND BLVD E
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City | TUSCALOOSA
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State | AL
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Zip | 35405-1803
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Country | US
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Telephone | 205-556-4180
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Fax | 205-556-7082
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Provider Business Mailing Address
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Address Line | 2615 MCFARLAND BLVD E
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City | TUSCALOOSA
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State | AL
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Zip | 35405-1803
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Country | US
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Telephone | 205-556-4180
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Fax | 205-556-7082
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH CHARLES PAIR
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Credential | OD
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Telephone | 205-556-4180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 5382
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License Number State | AL
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