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Contact Information

SALEM EYE CLINIC LLC
400 NORTH BROADWAY
SALEM, IL62881
 Phone: 618-548-3506
 Fax: 618-548-2555
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for SALEM EYE CLINIC LLC

NPI Number 1205980786
LBN Legal business name SALEM EYE CLINIC LLC
Authorized official ALAN MONTGOMERY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/22/2007
Last updated 03/28/2008 - About 18 years ago
Identifiers
IL Other 06132027 BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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