| Name: | Chaney Eye Care, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 28 May 2010 (14 years ago) |
| Entity Number: | 000-447-705 |
| Register Number: | 000447705 |
| County: | De Kalb |
| Place of Formation: | DeKalb County |
| Principal Address: | FORT PAYNE, AL |
| Registered Office Street Address: | 1953 GAULT AVE NORTHFORT PAYNE, AL 35967 |
| Registered Office Street Address ZIP Code: | 35967 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245542927 | 2010-07-09 | 2010-07-09 | 1953 GAULT AVE N, FORT PAYNE, AL, 359673417, US | 1953 GAULT AVE N, FORT PAYNE, AL, 359673417, US | |||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 256-845-5555 |
| Fax | 2569979310 |
Authorized person
| Name | DR. CHAD FREEMAN CHANEY |
| Role | OWNER |
| Phone | 2568455555 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | 17979 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009966025 |
| State | AL |
| Issuer | MEDICARE |
| Number | 051555126 |
| State | AL |
| Issuer | EYEMED INSURANCE |
| Number | AL0657 |
| Issuer | UPIN |
| Number | V01729 |
| Issuer | BCBS |
| Number | 051524862 |
| State | AL |
| Issuer | NPI INDIVIDUAL |
| Number | 1083763049 |
| Name | Role |
|---|---|
| CHANEY, CHAD FREEMAN | Member |
| Name | Role |
|---|---|
| CHANEY, CHAD FREEMAN | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
