Provider Demographics
NPI:1528260999
Name:NASHVILLE EYE CENTER OPTICAL
Entity type:Organization
Organization Name:NASHVILLE EYE CENTER OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:615-297-6548
Mailing Address - Street 1:4306 HARDING RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2205
Mailing Address - Country:US
Mailing Address - Phone:615-297-6548
Mailing Address - Fax:615-383-6719
Practice Address - Street 1:4306 HARDING RD
Practice Address - Street 2:SUITE 102
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2205
Practice Address - Country:US
Practice Address - Phone:615-297-6548
Practice Address - Fax:615-383-6719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0698390001Medicare NSC