| Name: | iCare EyeCare, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 21 Sep 2009 (15 years ago) |
| Entity Number: | 000-438-640 |
| Register Number: | 000438640 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | HOOVER, AL |
| Registered Office Street Address: | 3101 LORNA RD UNIT 821HOOVER, AL 35216 |
| Registered Office Street Address ZIP Code: | 35216 |
Activities
OPTOMETRIC SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689909996 | 2009-10-05 | 2015-01-14 | 2014 MORRIS AVE, BIRMINGHAM, AL, 352034108, US | 2014 MORRIS AVE, BIRMINGHAM, AL, 352034108, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 205-328-1744 |
| Fax | 2053284270 |
Authorized person
| Name | DR. VALENCIA ROBERTSON WELLS |
| Role | OWNER |
| Phone | 2053281744 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S-C08-TA-828 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PTAN |
| Number | 102G700056 |
| State | AL |
| Issuer | RAILROAD MEDICARE PTAN |
| Number | DU6174 |
| State | AL |
| Issuer | MEDICAID |
| Number | 151212 |
| State | AL |
| Name | Role |
|---|---|
| WELLS, VALENCIA ROBERTSON | Agent |
| Name | Role |
|---|---|
| WELLS, VALENCIA ROBERTSON | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
