Advantage Dental Oral Health and Vision Center of Alabama, P.C.
Organization Active NPI Optometrist · Athens, AL
NPI 1306153184 · NPPES record last updated Mar 4, 2024
Key facts
- NPI
- 1306153184
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- ADVANTAGE DENTAL ORAL HEALTH AND VISION CENTER OF ALABAMA, P.C.
- Practice address
- 310 W Elm St
Athens, AL 35611 - Phone
- (256) 262-0200
- Fax
- (256) 262-0201
- NPI assigned
- Sep 1, 2010
- Organization subpart
- No
Authorized official
- Name
- Sherrie Edmondson
- Title
- Manager, Licensing & Credentialing
- Phone
- (629) 999-5014
Corporate family (same tax ID) 30
National Provider Directory
- Tax ID family
- Advantage Dental Oral Health and Vision Center of Alabama PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
310 W Elm St
Athens, AL 35611
Mailing address
PO Box 411714
Boston, MA 02241-6805
Phone (629) 999-5014
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 217552 | Medicaid | AL |
Other providers in Athens, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.