Organization
MOUNTAIN EMPIRE CATARACT & EYE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BURTON (MANAGER)
(434) 661-7762
Entity
Organization
Contact information
Practice address
3185 W STATE ST, SUITE 2020, BRISTOL, TN 37620-1610
(423) 968-4141
(423) 968-7641
Mailing address
2010 BREMO RD STE 128A, RICHMOND, VA 23226-2444
(877) 969-0392
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
152
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010024676
—
VA
01
—
019997
ANTHEM
VA
01
—
4068468
BLUE CROSS BLUE SHIELD
TN
01
—
P00056474
RAILROAD MEDICARE
TN
01
—
TN0101
JOHN DEERE HEALTH CARE
TN
Enumeration date
08/30/2006
Last updated
03/11/2025
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