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Contact Information

MOBILE DIAGNOSTIC EYECARE
2750 MOUNT MORIAH PKWY
MEMPHIS, TN38115-2063
 Phone: 901-766-6742
 Fax: 901-766-6743
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
 

Exclusive Provider Organization

302F00000X
 

Optician

156FX1800X 96[5] Optician
 

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for MOBILE DIAGNOSTIC EYECARE

NPI Number 1871783274
LBN Legal business name MOBILE DIAGNOSTIC EYECARE
Authorized official DONNA HASTINGS - (LICENSED OPTICIAN/CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/31/2007
Last updated 08/08/2014 - About 12 years ago
Identifiers
TN License # 962
TN Other 4058078 BCBS
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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