| Blackston Quality Eye Care | |
|
1306 River Falls St, Andalusia, AL 36421-2081 | |
| (334) 222-6325 | |
| Not Available |
| Full Name | Blackston Quality Eye Care |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1306 River Falls St, Andalusia, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710028618 | NPI | - | NPPES |
| 0515-19208 | Other | AL | BLUE CROSS |
| 009943415 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | S-950-TA-529 (Alabama) | Primary |
| Provider Name | Kenny R Blackston |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740286301 PECOS PAC ID: 1153216791 Enrollment ID: I20040225000754 |
| Mailing Address | Practice Location Address |
|---|---|
| Blackston Quality Eye Care Po Box 638, Andalusia, AL 36420-1212 Ph: (334) 222-6325 | Blackston Quality Eye Care 1306 River Falls St, Andalusia, AL 36421-2081 Ph: (334) 222-6325 |
Dr. Richard Henry Merrill, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 406 E Three Notch St, Andalusia, AL 36420 Phone: 334-222-6632 Fax: 334-222-9828 | |
James L Barton, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 847 W Bypass Ste D, Andalusia, AL 36420 Phone: 334-222-8561 | |
Dr. James H Tillman Jr., O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1860 E Three Notch St, Andalusia, AL 36421 Phone: 334-222-2020 | |
Ensight Eyecare Optometrist Medicare: Medicare Enrolled Practice Location: 847 W Bypass Ste D, Andalusia, AL 36420 Phone: 334-222-8561 Fax: 334-222-5032 | |
Dr. David Andrew Hartzog, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 847 Western Bypass, Suite D, Andalusia, AL 36420 Phone: 334-222-8561 | |
Dr. Meredith Tillman Flatt, OD Optometrist Medicare: Medicare Enrolled Practice Location: 1860 E Three Notch St, Andalusia, AL 36421 Phone: 334-222-2020 Fax: 334-222-6506 | |
Andalusia Eye Clinic Llc Optometrist Medicare: Medicare Enrolled Practice Location: 1860 E Three Notch St, Andalusia, AL 36421 Phone: 334-222-2020 |