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Organization

RAINSVILLE EYE CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DIRK D MCGULLION OD (OPTOMETRIST)
(256) 638-2020
Entity
Organization

Contact information

Practice address
463 MAIN ST W., RAINSVILLE, AL 35986
(256) 638-2020
(256) 638-7832
Mailing address
PO BOX 2120, RAINSVILLE, AL 35986-2120
(256) 638-2020
(256) 638-7832

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
S818TA058
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1126930001
MEDICARE DME
AL
05
529503630
AL
01
58647
BCBS
AL
Enumeration date
11/13/2007
Last updated
02/19/2010
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