MEDICARE: ALTADENA EYE CARE

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1528670080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTADENA EYE CARE

Provider Business Mailing Address
First Line	:	3477 WATER OAK DR
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-4430
Country	:	US
Telephone Number	:	205-298-8420
Fax Number	:

Provider Business Practice Location Address
First Line	:	2409 ACTON RD STE 161
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-2939
Country	:	US
Telephone Number	:	205-542-3357
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. AMY HAMM HERRINGTON
Credential	:	OD
Telephone Number	:	205-542-3357

Provider Enumeration Date	:	08/17/2020
Last Update Date	:	08/17/2020

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Directions to “ALTADENA EYE CARE ” Practice Location

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