Provider Demographics
NPI:1528670080
Name:ALTADENA EYE CARE
Entity type:Organization
Organization Name:ALTADENA EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:HAMM
Authorized Official - Last Name:HERRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-542-3357
Mailing Address - Street 1:3477 WATER OAK DR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-4430
Mailing Address - Country:US
Mailing Address - Phone:205-298-8420
Mailing Address - Fax:
Practice Address - Street 1:2409 ACTON RD STE 161
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-2939
Practice Address - Country:US
Practice Address - Phone:205-542-3357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center