Organization
RAINBOW CITY FAMILY EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA V WALL (OFFICE MANAGER)
(256) 442-9350
Entity
Organization
Contact information
Practice address
115 W GRAND AVE, SUITE 120, RAINBOW CITY, AL 35906-3275
(256) 442-9350
(256) 442-9352
Mailing address
115 W GRAND AVE, SUITE 120, RAINBOW CITY, AL 35906-3275
(256) 442-9350
(256) 442-9352
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
S-732-TA-108
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009946420
—
AL
Enumeration date
09/14/2007
Last updated
08/19/2011
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