MEDICARE: RICHARD C. ORGAIN

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	TN0661	TN
2	332H00000X	Eyewear Supplier	TN0661	TN

General Provider Information

NPI Number	:	1598942401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD C. ORGAIN

Provider Business Mailing Address
First Line	:	131 INDIAN LAKE RD
Second Line	:	SUITE 100
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-3866
Country	:	US
Telephone Number	:	615-824-5486
Fax Number	:	615-824-1770

Provider Business Practice Location Address
First Line	:	131 INDIAN LAKE ROAD
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-3886
Country	:	US
Telephone Number	:	615-824-5486
Fax Number	:	615-824-1770

Authorized Official
Title or Position	:	INSURANCE CLERK
Name	:	MRS. HEATHER E. STEFFY
Credential	:
Telephone Number	:	615-824-5486

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	08/06/2012

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