Eufaula Eye Associates, Inc.
Organization Active NPI Optometrist · Eufaula, AL
NPI 1053478701 · NPPES record last updated Feb 3, 2010
Key facts
- NPI
- 1053478701
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- S387TA013 (AL)
- Legal business name
- EUFAULA EYE ASSOCIATES, INC.
- Practice address
- 138 E Broad St
Eufaula, AL 36027-2024 - Phone
- (334) 687-2545
- Fax
- (334) 687-6491
- NPI assigned
- Jan 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Hernan Benavides, O.D.
- Title
- Owner
- Phone
- (334) 687-2545
Practitioners 2
-
Hernan G. Benavides, O.D.
-
Laura B Osmer, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070910000364 | AL | Part B Supplier - Clinic/Group Practice | 2860585783 |
Receives reassigned benefits from 2 practitioners Practice locations: Eufaula, AL |
National Provider Directory
Locations
138 E Broad St
Eufaula, AL 36027
Phone (205) 687-2545
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | S387TA013 | AL | Yes |
Addresses
Primary practice location
138 E Broad St
Eufaula, AL 36027-2024
Mailing address
PO Box 635
Eufaula, AL 36072-0635
Phone (334) 687-2545
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000267495B | Medicaid | GA | |
| 528802120 | Medicaid | AL | |
| 000059471 | Medicaid | AL | |
| 51059471 | Other | AL | BCBS OF AL |
Other providers in Eufaula, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.