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Organization

MORELAND EYECARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AMBER RENEE MORELAND OD (OPTOMETRIST)
(618) 521-9679
Entity
Organization

Contact information

Practice address
100 PEACH RIDGE RD, ANNA, IL 62906-2242
(618) 833-9208
Mailing address
100 PEACH RIDGE RD, ANNA, IL 62906-2242
(618) 833-9208

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009756
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046009756
IL
01
09132017
BLUE CROSS BLUE SHIELD
Enumeration date
04/23/2007
Last updated
07/14/2009
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