Basic Information
| Provider Information | |||||||||
| NPI: | 1679946487 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SCHAEFFER EYE CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 1310 | ||||||||
| Address2: | SCHAEFFER EYE CENTER | ||||||||
| City: | TRUSSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351731376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058247171 | ||||||||
| FaxNumber: | 2058247179 | ||||||||
| Practice Location | |||||||||
| Address1: | 24810 U.S HWY. 31 | ||||||||
| Address2: | |||||||||
| City: | JEMISON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056881010 | ||||||||
| FaxNumber: | 2056883802 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2015 | ||||||||
| LastUpdateDate: | 11/03/2015 | ||||||||
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| AuthorizedOfficialLastName: | SCHAEFFER | ||||||||
| AuthorizedOfficialFirstName: | JACK | ||||||||
| AuthorizedOfficialMiddleName: | L. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2058247171 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SCHAEFFER EYE CENTER, INC. | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.