| |
223 Pierson Ave, Centreville, AL 35042-2919 | |
(205) 926-4816 | |
(888) 803-4916 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 223 Pierson Ave, Centreville, Alabama |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548434657 | NPI | - | NPPES |
000059437 | Medicaid | AL | |
S-374-TA-005 | Other | AL | AL LICENSE |
406183603 | Other | AL | RRTRAV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
332H00000X | Eyewear Supplier | S-374-TA-005 (Alabama) | Secondary |
Mailing Address | Practice Location Address |
---|---|
223 Pierson Ave, Centreville, AL 35042-2919 Ph: (205) 926-4816 | 223 Pierson Ave, Centreville, AL 35042-2919 Ph: (205) 926-4816 |
Charles D Allgood, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 223 Pierson Ave, Centreville, AL 35042 Phone: 205-926-4816 Fax: 888-803-4916 |