| Name: | The EyeCare Place, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 10 Jun 2004 (20 years ago) |
| Entity Number: | 000-235-760 |
| Register Number: | 000235760 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 960 EDWARDS LAKE RDBIRMINGHAM, AL 35235 |
| Registered Office Street Address ZIP Code: | 35235 |
| Authorized Capital: | $1,000 |
Activities
PROVIDE LOCATIONS WHERE OPTOMETRISTS SVC MEDICAID PARTICIPANTS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679548044 | 2006-02-21 | 2013-08-14 | 1627 CENTER POINT PKWY, CENTER POINT, AL, 352155503, US | 1627 CENTER POINT PKWY, CENTER POINT, AL, 352155503, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 205-856-1522 |
Authorized person
| Name | DR. LAURA ARTHUR WHITE |
| Role | PRESIDENT |
| Phone | 2058561522 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S857TA416 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 156FX1800X - Optician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529920160 |
| State | AL |
| Issuer | BCBS OF ALABAMA |
| Number | 51528231 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| MOSES, ANNE R | Incorporator | 300 CAHABA PARK CIRCLE STE 100BIRMINGHAM, AL 35242 |
| Name | Role |
|---|---|
| WHITE, LAURA A | Agent |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
