Riverbend Eyecare, P.A.

LBN: Riverbend Eyecare, P.A.
Riverbend Eyecare, P.A. is an health care organization with primary practice located at 3505 Pemberton Square Blvd Suite 45, Vicksburg MS 39180-5537. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Riverbend Eyecare, P.A. can be contacted via phone (601) 630-9199, or through Prudhomme, David L. via phone (601) 630-9199.

Contact Information

Primary practice address
3505 Pemberton Square Blvd Suite 45 Vicksburg MS 39180-5537
Phone: (601) 630-9199
Fax: (601) 630-0426
Website:
Map and Directions
Authorized official contact:
Name: Prudhomme, David L. Doctor of Optometry (OD)
Phone: (601) 630-9199

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X MS579 Mississippi

Profile Details

NPI number 1811957624
LBN Legal business name Riverbend Eyecare, P.A.
DBA Doing business as
Authorized official Prudhomme, David L. Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 24th, 2006
Last updated Oct 15th, 2012 - about 12 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 1811957624 NPPES
Mississippi MEDICAID 00880004

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