Fountain City Eyecare LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

S983TA555 Issued in AL

Legal business name

FOUNTAIN CITY EYECARE LLC

Practice address

1807 Station Dr
Suite a
Prattville, AL 36066-5664

Phone

(334) 358-2440

NPI assigned

Dec 11, 2006

Last updated

May 25, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. George Nicholas Eischens, O.D.

Title

Owner Ceo

Phone

(334) 358-2440

Specialties & licenses 2

Addresses

Other identifiers 5

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1245390459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 STATION DR",
            "address_2": "SUITE A",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 STATION DR",
            "address_2": "SUITE A",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665664",
            "telephone_number": "334-358-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN CITY EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2010-05-25",
        "status": "A",
        "authorized_official_last_name": "EISCHENS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "334-358-2440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S983TA555",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "AL",
            "license": "S983TA555",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529911890",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "22-00012",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051509621",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051509621",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00201800",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Lee Flores
• Andrea L Foster, PHARMD
• Brianna Foster, CCC-SLP
• Chelby Foster
• Fountain City Chiropractic LLC
• Fountain City Speech Therapy, LLC
• Steven Jay Frawley, RPH
• Lucius Bedford Freeman, MD
• Teran Renee Fulford, SPEECH THERAPIST
• Tyeisha Fuller, PT, DPT

• Optometrist in Prattville, AL
• Providers in Prattville, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.