Organization

Shenandoah Eye Clinic

May also be knows as The Lens Source

Eyewear Supplier in Baton Rouge, LA(View on Map)

Legal Business Name

Shenandoah Eye Clinic

Also Known As

The Lens Source

NPI Number

1497707780

NPI Type

Organization

Enumeration Date

05/16/2006

Specialties

(Taxonomies)

Code

332H00000X
152WC0802X
152W00000X
152WS0006X

Primary Taxonomy

Yes
No
No
No

Licenses

State

Louisiana

License Number

LA773206T

Contact
Information

Purpose

Mailing
Location

Address

5237 JONES CREEK ROAD
5237 JONES CREEK ROAD

City

Baton Rouge
Baton Rouge

State

LA
LA

Postal Code

70817-2124
70817-2124

Country

US
US

Telephone Number

(225) 755-3937
(225) 755-3937

Authorized Official

Name

Dr. Edwin Adams

Title or Position

OPTOMETRIST/OWNER/CEO

Telephone Number

(225) 755-3937

Identifiers

Identifier

0699540001
1196519

Identifier State

LA
LA

Identifier Issuer

MEDICARE SUPPLIER #
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/09/2014

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