Blackston Quality Eye Care

LBN: Kenny R Blackston Od Pc
Blackston Quality Eye Care is an health care organization with primary practice located at 106 Hillcrest Dr , Andalusia AL 36420-2562. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Kenny R Blackston Od Pc can be contacted via phone (334) 222-6325, or through Blackston, Stephanie via phone (334) 222-6325.

Contact Information

Primary practice address
106 Hillcrest Dr Andalusia AL 36420-2562
Phone: (334) 222-6325
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Blackston, Stephanie
Phone: (334) 222-6325

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X S-950-TA-529 Alabama

Profile Details

NPI number 1710028618
LBN Legal business name Kenny R Blackston Od Pc
DBA Doing business as Blackston Quality Eye Care
Authorized official Blackston, Stephanie
Entity Organization
Organization subpart 1 No
Enumeration date Feb 12th, 2007
Last updated Mar 8th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710028618 NPPES
Alabama Other 0515-19208 BLUE CROSS
Alabama MEDICAID 009943415 BLUE CROSS

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