Provider Demographics
NPI:1871335240
Name:ATHENS EYE CARE LLC
Entity type:Organization
Organization Name:ATHENS EYE CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-549-7757
Mailing Address - Street 1:1077 BAXTER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3767
Mailing Address - Country:US
Mailing Address - Phone:706-549-7757
Mailing Address - Fax:706-549-7757
Practice Address - Street 1:1077 BAXTER ST STE 100
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3767
Practice Address - Country:US
Practice Address - Phone:706-549-7757
Practice Address - Fax:706-549-7757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty