MEDICARE: HELENA VISION 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
1	152W00000X	Optometrist	SB51TA690	AL

General Provider Information

NPI Number	:	1083041537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELENA VISION CARE, LLC

Provider Business Mailing Address
First Line	:	5358 HIGHWAY 17
Second Line	:
City	:	HELENA
State	:	AL
Zip	:	35080-3604
Country	:	US
Telephone Number	:	205-664-7577
Fax Number	:	205-664-7654

Provider Business Practice Location Address
First Line	:	5358 HIGHWAY 17
Second Line	:
City	:	HELENA
State	:	AL
Zip	:	35080-3604
Country	:	US
Telephone Number	:	205-664-7577
Fax Number	:	205-664-7654

Authorized Official
Title or Position	:	OPTOMETIST/OWNER
Name	:	JAMIE REID
Credential	:	OD
Telephone Number	:	205-664-7577

Provider Enumeration Date	:	09/30/2013
Last Update Date	:	10/06/2023

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